Boo Hammas Karin, Jacobsen Juliet, Selberg Rebecca, Mahajan Sanjoy, Klintman Jenny
Department of Clinical Sciences Lund, Medical Oncology, Lund University, Sweden; Department of Specialised Palliative Care, Advanced Home Health Care, Kristianstad, Sweden.
Department of Clinical Sciences Lund, Medical Oncology, Lund University, Lund, Sweden; Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA.
Acta Oncol. 2025 May 14;64:672-676. doi: 10.2340/1651-226X.2025.43308.
Few studies, in Sweden or internationally, have examined gender differences regarding the use of palliative care. This study investigates gender differences in palliative care needs prior to referral in a regional cohort of Swedish cancer patients. Patient/material and methods: Adult cancer patients who died throughout 1 year and were referred to a specialized palliative care service in southern Sweden during their last 3 years of life (n = 192) were included. Information on gender, age, diagnosis, performance status, admissions to hospital, and serious illness conversations was collected through chart review.
Ninety-nine (52%) women and 93 (48%) men were included. Survival from diagnosis until death was comparable (p = 0.27) for women (341.0 days, IQR 77.0-902.0) and men (463.0 days, IQR 141.0-1035.0), as was survival from palliative care referral (p = 0.06) (women 48.0 days, IQR 19.0‑107.5; men 36.0 days, IQR 17.0‑85.0). Performance status at the time of referral was also comparable (p = 0.59). Gender differences were observed in healthcare utilization with fewer hospitalizations and emergency department visits for women in the 6 months prior to referral (p = 0.03) and significantly more men among those with the highest healthcare utilization (≥4 hospitalizations and emergency department visits) (p = 0.005). During the month before referral, women were more likely to have a serious illness conversation (p = 0.01).
Compared to women, men have more hospitalizations and fewer serious illness conversations prior to referral to specialized palliative care, suggesting greater unmet palliative care needs.
在瑞典或国际上，很少有研究探讨姑息治疗使用方面的性别差异。本研究调查瑞典癌症患者区域队列中转诊前姑息治疗需求的性别差异。患者/材料与方法：纳入在其生命的最后3年中于瑞典南部死亡且转诊至专门姑息治疗服务机构的成年癌症患者（n = 192）。通过病历审查收集有关性别、年龄、诊断、体能状态、住院情况和重病谈话的信息。
纳入99名（52%）女性和93名（48%）男性。女性（341.0天，四分位数间距77.0 - 902.0）和男性（463.0天，四分位数间距141.0 - 1035.0）从诊断到死亡的生存期相当（p = 0.27），从姑息治疗转诊后的生存期也相当（p = 0.06）（女性48.0天，四分位数间距19.0 - 107.5；男性36.0天，四分位数间距17.0 - 85.0）。转诊时的体能状态也相当（p = 0.59）。在转诊前6个月的医疗保健利用方面观察到性别差异，女性的住院和急诊就诊次数较少（p = 0.03），在医疗保健利用率最高（≥4次住院和急诊就诊）的人群中男性明显更多（p = 0.005）。在转诊前一个月，女性更有可能进行重病谈话（p = 0.01）。
与女性相比，男性在转诊至专门姑息治疗之前住院次数更多，重病谈话次数更少，这表明未满足的姑息治疗需求更大。
