ArticleJournal of the National Cancer Institute2017
Aggressive End-of-Life Care for Metastatic Cancer Patients Younger Than Age 65 Years.
Article in Journal of the National Cancer Institute, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Geographic and sociodemographic access to systemic anticancer therapies for secondary breast cancer: a systematic review.Systematic reviews · 2024Pooled it
- Lung cancer and end-of-life care: a systematic review and thematic synthesis of aggressive inpatient care.BMJ supportive & palliative care · 2019Pooled it
- Aggressive end-of-life care among over half a million patients with cancer in Shandong, China, 2017-2022.Journal of global health · 2026Article
- Place of Death Among Early-Onset Colorectal Cancer Decedents in the United States, 1999-2020: National Trends and Disparities.Journal of gastrointestinal cancer · 2026Article
- Comparison of Health Care Cost Trajectories in the Last Year of Life by Age at Death.JAMA network open · 2026Article
- An analysis of palliative care in adolescents and young adults with soft tissue and bone sarcomas.Palliative care and social practice · 2026Article
- Palliative care use and end-of-life care quality in HR+/HER2- metastatic breast cancer.Breast cancer research and treatment · 2025Article
- End-of-life care in glioblastoma: A population-based study.Neuro-oncology · 2025Article
- Trends and disparities in place of death among patients with cholangiocarcinoma: A two-decade analysis.Palliative & supportive care · 2025Article
- End-of-Life Systemic Oncologic Treatment in the Immunotherapy Era: The Role of Race, Insurance, and Practice Setting.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- Systemic Anticancer Treatment Near the End of Life: a Narrative Literature Review.Current treatment options in oncology · 2023Review
- Effect of the COVID-19 Pandemic on Place of Death Among Medicaid and Commercially Insured Patients With Cancer in Washington State.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Article
- End-of-Life Care for Patients With Metastatic Renal Cell Carcinoma in the Era of Oral Anticancer Therapy.JCO oncology practice · 2023Article
- Social determinants of health and lung cancer surgery: a qualitative study.Frontiers in public health · 2023Article
- Changes in the treatment rate of patients newly diagnosed with stage IV cancer near the end of life from 2012 to 2017 in Korea.Epidemiology and health · 2023Article
- A prospective cohort study assessing aggressive interventions at the end-of-life among patients with solid metastatic cancer.BMC palliative care · 2022Article
- Development of a Machine Learning Model Using Limited Features to Predict 6-Month Mortality at Treatment Decision Points for Patients With Advanced Solid Tumors.JCO clinical cancer informatics · 2022Article
- Disparities in Care Management During Terminal Hospitalization Among Adults With Metastatic Cancer From 2010 to 2017.JAMA network open · 2021Observational
- Early-onset pancreatic cancer: an institutional series evaluating end-of-life care.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Intensity of End-of-Life Care in a Cohort of Commercially Insured Women With Metastatic Breast Cancer in the United States.JCO oncology practice · 2021Article
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Authors and funding
6 authors at 2 institutions in 3 countries.
Funding
Abstract
Background: Aggressive medical care at the end of life can be harmful to patients and families, but its prevalence in use among younger cancer patients is unknown. The goal of the study was to report on the use of aggressive care and hospice services for patients younger than age 65 years. Methods: Using the HealthCore Integrated Research Database, we analyzed patients who died between 2007 and 2014 with metastatic lung (n = 12 764), colorectal (n = 5207), breast (n = 5855), pancreatic (n = 3397), or prostate (n = 1508) cancer. Based on published quality measures, we assessed uses of chemotherapy, intensive care, emergency room visits, and hospice care at the end of life. We examined additional items including radiotherapy, invasive procedures, hospitalization, and in-hospital deaths. Multivariable modified Poisson regression models were used to adjust for age, sex, geographic region, rural/urban location, year of death, and regional education and income measures. Results: Across the five cancers, 10.1% to 14.1% of patients received chemotherapy within the last 14 days of life, 15.9% to 20.6% received intensive care in last 30 days, and 1.5% to 2.5% went to the emergency room two or more times in last 30 days. Hospice enrollment at least three days before death was 54.4% to 59.6%. However, 55.3% to 59.3% of patients had a hospital admission in the last 30 days, and one-third died (30.3%-35.4%) in the hospital. Conclusions: There was low use of cancer-directed treatment at the end of life for younger cancer patients, and hospice use was higher than 50%. However, there was a relatively high utilization of hospital-based care. These results demonstrate an opportunity for continued improvements in the provision of high-value, patient-centered care at the end of life.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.