Garg Shriya K, Kohli Khushi, Garg Isha K, Garg Yash K, Nguyen Lilac G, Nguyen Isabella S, Feliciano Erin Jay G, Baez Yefri A, Mahal Brandon A, Iyengar Puneeth, Gomez Daniel R, Lapen Kaitlyn, Dee Edward Christopher
University of Georgia, Athens, Georgia, USA.
Harvard University, Cambridge, Massachusetts, USA.
Cancer. 2025 May 15;131(10):e35903. doi: 10.1002/cncr.35903.
Despite palliative-intent interventions' ability to improve the quality of life of patients, significant inequalities persist in uptake. Such disparities are characterized by racial, socioeconomic, and geographic factors. However, less is known among disaggregated Hispanic populations. This study examines disparities in the receipt of palliative-intent interventions among Hispanic subgroups with advanced lung, breast, and prostate cancer.
Via the National Cancer Data Base, data were collected on the receipt of palliative-intent interventions among Hispanic subgroups diagnosed with American Joint Committee on Cancer analytic stage IV breast, lung, and prostate cancer between 2004 and 2021. Multivariate logistic regressions were conducted to quantify differences in the uptake of palliative-intent care among Hispanic subgroups.
Among 945,894 total patients, disaggregated analyses revealed reduced receipt of palliative-intent interventions for patients with lung, breast, and prostate cancer of Mexican descent (lung, p < .001; breast, p < .001; prostate, p = .03) compared to non-Hispanic White patients. Receipt for patients of South or Central American descent was reduced in comparison to non-Hispanic White patients for lung and breast cancer (lung, p < .001; breast, p < .001). Uptake of palliative interventions for metastatic lung and breast cancer was reduced for patients of Cuban descent (lung, p < .001; breast, p = .03), and was lower for patients of Dominican descent with breast cancer, compared to non-Hispanic White patients (p = .05).
These findings demonstrate disparities in the receipt of palliative-intent interventions among disaggregated Hispanic subgroups. This study highlights the need for disaggregated research to further characterize these disparities and their drivers. Community-level and patient-centric efforts may help to address these inequities.
尽管姑息性干预措施有能力改善患者的生活质量，但在接受情况方面仍存在显著的不平等。这种差异的特征在于种族、社会经济和地理因素。然而，在细分的西班牙裔人群中，人们对此了解较少。本研究调查了晚期肺癌、乳腺癌和前列腺癌的西班牙裔亚组在接受姑息性干预措施方面的差异。
通过国家癌症数据库，收集了2004年至2021年间被诊断为美国癌症联合委员会分析分期IV期乳腺癌、肺癌和前列腺癌的西班牙裔亚组接受姑息性干预措施的数据。进行多因素逻辑回归以量化西班牙裔亚组在接受姑息性护理方面的差异。
在总共945,894名患者中，分类分析显示，与非西班牙裔白人患者相比，墨西哥裔肺癌、乳腺癌和前列腺癌患者接受姑息性干预措施的比例降低（肺癌，p <.001；乳腺癌，p <.001；前列腺癌，p =.03）。与非西班牙裔白人患者相比，南美洲或中美洲裔肺癌和乳腺癌患者的接受比例降低（肺癌，p <.001；乳腺癌，p <.001）。古巴裔转移性肺癌和乳腺癌患者接受姑息性干预措施的比例降低（肺癌，p <.001；乳腺癌，p =.03），与非西班牙裔白人患者相比，多米尼加裔乳腺癌患者的接受比例较低（p =.05）。
这些发现表明，在细分的西班牙裔亚组中，接受姑息性干预措施存在差异。本研究强调需要进行分类研究，以进一步描述这些差异及其驱动因素。社区层面和以患者为中心的努力可能有助于解决这些不平等问题。
