Department of Radiation Oncology, Duke University Medical Center, DUMC Box 3085, Durham, NC 27710, USA.
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Oral Oncol. 2020 Mar;102:104555. doi: 10.1016/j.oraloncology.2019.104555. Epub 2020 Jan 29.
Evaluate trends in place of death for patients with head and neck cancers (HNC) in the U.S. from 1999 to 2017 based on the CDC WONDER (Wide-ranging Online Data for Epidemiologic Research) database.
MATERIALS/METHODS: Using patient-level data from 2015 and aggregate data from 1999 to 2017, multivariable logistic regression analyses (MLR) were performed to evaluate for disparities in place of death.
We obtained aggregate data for 101,963 people who died of HNC between 1999 and 2017 (25.9% oral cavity, 24.6% oropharynx/pharynx, 0.4% nasopharynx, and 49.1% larynx/hypopharynx). Most were Caucasian (92.7%) and male (87.0%). Deaths at home or hospice increased over the study period (R = 0.96, p < 0.05) from 29.2% in 1999 to 61.2% in 2017. On MLR of patient-level data from 2015, those who were single (ref), ages 85+ (OR 0.78; 95% CI: 0.68, 0.90), African American (OR 0.73; 95% CI: 0.65, 0.82), or Asian/Pacific Islanders (OR 0.66; 95% CI: 0.54, 0.81) were less likely to die at home or hospice. On MLR of the aggregate data (1999-2017), those who were female (OR 0.87; 95% CI: 0.83, 0.91) or ages 75-84 (OR 0.79; 95% CI: 0.76, 0.82) were also less likely to die at home or hospice. In both analyses, those who died from larynx/hypopharynx cancers were less likely to die at home or hospice.
HNC-related deaths at home or hospice increased between 1999 and 2017. Those who were single, female, African American, Asian/Pacific Islander, older (ages 75+), or those with larynx/hypopharynx cancers were less likely to die at home or hospice.
基于疾病预防控制中心 Wonder（广泛在线数据用于流行病学研究）数据库，评估 1999 年至 2017 年美国头颈部癌症（HNC）患者死亡地点的趋势。
材料/方法：使用 2015 年的患者水平数据和 1999 年至 2017 年的汇总数据，进行多变量逻辑回归分析（MLR），以评估死亡地点的差异。
我们获得了 1999 年至 2017 年间 101963 例 HNC 死亡患者的汇总数据（25.9%口腔癌，24.6%口咽癌/咽癌，0.4%鼻咽癌，49.1%喉癌/下咽癌）。大多数为白种人（92.7%）和男性（87.0%）。在研究期间，在家中或临终关怀机构死亡的比例有所增加（R=0.96，p<0.05），从 1999 年的 29.2%增加到 2017 年的 61.2%。在对 2015 年患者水平数据的 MLR 分析中，单身者（参考）、85 岁以上者（OR 0.78；95%CI：0.68，0.90）、非裔美国人（OR 0.73；95%CI：0.65，0.82）或亚裔/太平洋岛民（OR 0.66；95%CI：0.54，0.81）不太可能在家中或临终关怀机构死亡。在汇总数据的 MLR 分析中（1999-2017 年），女性（OR 0.87；95%CI：0.83，0.91）或 75-84 岁（OR 0.79；95%CI：0.76，0.82）的患者也不太可能在家中或临终关怀机构死亡。在这两种分析中，死于喉癌/下咽癌的患者不太可能在家中或临终关怀机构死亡。
1999 年至 2017 年间，在家中或临终关怀机构的 HNC 相关死亡人数有所增加。单身、女性、非裔美国人、亚裔/太平洋岛民、年龄较大（75 岁以上）或患有喉癌/下咽癌的患者不太可能在家中或临终关怀机构死亡。
