Sharpe Katharine H, Cezard Genevieve, Bansal Narinder, Bhopal Raj S, Brewster David H
Information Services Division, NHS National Services Scotland, Edinburgh, UK.
Centre for Population Health Sciences Edinburgh University Medical School, Edinburgh, UK.
BMJ Support Palliat Care. 2015 Dec;5(4):443-51. doi: 10.1136/bmjspcare-2013-000485. Epub 2013 Nov 19.
Place of cancer death varies ethnically and internationally. Palliative care reviews highlight limited ability to demonstrate equal access due to incomplete or unreliable ethnicity data.
To establish place of cancer death by ethnicity and describe patient characteristics.
We linked census, hospital episode and mortality data for 117 467 persons dying of cancer, 2001-2009. With White Scottish population as reference, prevalence ratios (PR), 95% CIs and p values of death in hospital, home or hospice adjusted for sex and age were calculated by ethnic group.
White Scottish group and minority ethnic groups combined constituted 91% and 0.4% of cancer deaths, respectively. South Asian, Chinese and African Origin patients were youngest at death (66, 66 and 65.9 years). Compared with the Scottish White reference, the White Irish (1.15 (1.10 to 1.22), p<0.0001) and Other White British (1.07 (1.02 to 1.12), p=0.003) groups were more likely to die at home. Generally, affluent Scottish White patients were less likely to die in hospital and more likely to die at home or in a hospice regardless of socioeconomic indicator used.
Cancer deaths occur most often in hospital (52.3%) for all ethnic groups. Regardless of the socioeconomic indicator used, more affluent Scottish White patients were less likely to die in hospital; existing socioeconomic indicators detected no clear trend for the non-White population. Regardless of ethnic group, significant work is required to achieve more people dying at home or the setting of their choice.
癌症死亡地点在不同种族和国际间存在差异。姑息治疗评估强调，由于种族数据不完整或不可靠，难以证明平等获得治疗的情况。
按种族确定癌症死亡地点并描述患者特征。
我们将2001年至2009年期间117467名癌症死亡患者的人口普查、医院病历和死亡率数据进行了关联。以苏格兰白人人口为参照，按种族计算了经性别和年龄调整后的在医院、家中或临终关怀机构死亡的患病率比值（PR）、95%置信区间和p值。
苏格兰白人组和少数族裔组分别占癌症死亡人数的91%和0.4%。南亚、华裔和非洲裔患者死亡时最年轻（分别为66岁、66岁和65.9岁）。与苏格兰白人参照组相比，爱尔兰白人组（1.15（1.10至1.22），p<0.0001）和其他英国白人组（1.07（1.02至1.12），p=0.003）在家中死亡的可能性更高。总体而言，无论使用何种社会经济指标，富裕的苏格兰白人患者在医院死亡的可能性较小，在家中或临终关怀机构死亡的可能性较大。
所有种族的癌症死亡大多发生在医院（52.3%）。无论使用何种社会经济指标，富裕的苏格兰白人患者在医院死亡的可能性较小；现有的社会经济指标未发现非白人人群的明显趋势。无论种族如何，都需要开展大量工作，以使更多人在家中或他们选择的环境中死亡。
