Evidence map›Paper›PMID 41526756›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026

End-of-life emergency medical service transport among patients with terminal cancer by cardiopulmonary arrest status: A nationwide mortality follow-back survey.

Yoko Nakazawa, Mitsunori Miyashita, Tatsuya Morita, Yoshiyuki Kizawa, Yasuyuki Okumura, Shohei Kawagoe, Hiroshi Yamamoto, Emi Takeuchi, Risa Yamazaki, Asao Ogawa

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Yoko NakazawaDivision of Policy Evaluation, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan. ynakazaw@ncc.go.jp.
Mitsunori MiyashitaDepartment of Palliative Nursing, Graduate School of Medicine, Tohoku University, Sendai, Japan.
Tatsuya MoritaDepartment of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan.
Yoshiyuki KizawaDepartment of Palliative and Supportive Care, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Yasuyuki OkumuraInitiative for Clinical Epidemiological Research, Tokyo, Japan.
Shohei KawagoeAozora Clinic, Matsudo, Japan.
Hiroshi YamamotoDepartment of Respiratory Medicine, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
Emi TakeuchiDivision of Quality Assurance Programs, Institute for Cancer Control, National Cancer Center, Tokyo, Japan.
Risa YamazakiDepartment of Medical Psychology, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan.
Asao OgawaDivision of Psycho-Oncology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Japan.

Funding

The Ministry of Health, Labor, and Welfare, Japan 24EA1005
6 · The paper itself

Abstract

purposeEmergency medical service (EMS) transport during the terminal stages of cancer may result in cardiopulmonary arrest (CPA) and resuscitation, which may not align with patient preferences. The characteristics and care experiences of CPA patients have not been well studied in Japan. We described the characteristics and end-of-life (EOL) care experiences of terminal cancer patients with and without CPA at EMS transport.

methodsWe conducted a secondary analysis of a nationwide mortality follow-back survey (2019-2020) using structured questionnaires completed by bereaved family members linked to death certificate data. We analyzed 4,939 patients with terminal cancer who were transported by EMS in the final month of life and died in hospitals between 2017 and 2018. The patients were categorized according to their CPA status at EMS transport.

resultsAmong the 4,939 patients, 178 (3.6%) experienced CPA during EMS transport. The CPA group had a higher proportion of lung cancers and lower proportion of colorectal and hepatobiliary/pancreatic cancers. They were less likely to have a do-not-resuscitate (DNR) order (55.9% vs. 92.6%) or to have engaged in resuscitation (46.5% vs. 62.1%) or EOL discussions (39.5% vs. 50.8%). In addition, the CPA group reported lower out-of-pocket medical expenses (41.2% under ¥100,000 versus 21.7%), lower symptom burden, and a slightly higher perceived quality of death.

conclusionsPatients transported in CPA experienced fewer EOL discussions, showed socioeconomic disparities, and had distinct perceptions of the quality of death. These findings emphasize the need to enhance advanced care planning communication and emergency preparedness in EOL cancer care.

Indexed as

Emergency Medical ServicesHeart ArrestNeoplasmsTerminal CareTransportation of PatientsAgedAged, 80 and overCardiopulmonary ResuscitationFemaleHumansJapanMaleMiddle AgedResuscitation OrdersSurveys and QuestionnairesAdvance care planningBereavementCardiopulmonary arrestEmergency medical servicesNeoplasmsPalliative careResuscitationTerminal care

Identifiers

PMID41526756

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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.