Young adults palliative care use remains low in advanced cancer study
A JAMA Network Open study found palliative care rose from 2010 to 2023 but remained uncommon for young adults with advanced cancer.
By Priya Raghavan · Science Reporter
2 min read
Young adults palliative care use remained limited among patients treated for advanced cancer, despite gains over more than a decade, according to a research letter in JAMA Network Open. The finding matters because palliative care can be delivered during cancer treatment to help with symptoms, treatment choices and quality of life, according to Kewei Sylvia Shi of the American Cancer Society.
Shi and colleagues studied National Cancer Database records for 67,706 patients ages 18 to 39. All were newly diagnosed with a first primary stage 4 solid tumor or a poor-prognosis high-grade brain tumor, the researchers reported.
The cohort included 62,072 patients with stage 4 solid tumors and 5,634 patients with poor-prognosis high-grade brain tumors. The study compared young adults who received cancer-directed systemic therapy alone with those who received systemic therapy and palliative care during their first course of treatment.
How often do young adults with advanced cancer get palliative care?
The researchers found that concurrent palliative care use was low across the study period, although it increased from 9.3% in 2010 to 18.3% in 2023. For the most recent period analyzed, 2,715 patients, or 17.1%, received both palliative care and cancer-directed systemic therapy from 2021 through 2023.
Palliative care is medical support focused on easing symptoms and helping patients and families with decisions during serious illness. In cancer, it can be provided alongside treatment aimed at the disease, rather than only at the end of life.
Shi said in a statement that palliative care can help patients address symptoms, support decision-making and improve quality of life during treatment, but many young adults still do not receive those services.
Which cancer groups had the highest and lowest use?
Use differed sharply by cancer type, according to the research letter. The highest rates of concurrent palliative care were reported among young adults with lung cancer at 39.1%, gastric cancer at 32.6%, kidney cancer at 29.9%, female breast cancer at 28.2% and pancreatic cancer at 27.6%.
The lowest rates were found among patients with Hodgkin lymphoma at 1.9%, non-Hodgkin lymphoma at 4.1%, poor-prognosis brain tumors at 4.3% and head and neck cancers at 4.4%, the researchers reported.
The study also found demographic and treatment-setting differences. Compared with patients who received cancer-directed therapy alone, those receiving concurrent palliative care were more likely to be ages 35 to 39, female, insured by Medicaid and treated at community cancer programs, according to Shi and colleagues.
The research letter, titled “Concurrent Palliative Care and Systemic Treatment Among Young Adults With Advanced Cancer,” was published online July 23 in JAMA Network Open. Two authors disclosed ties to the pharmaceutical industry.
This story draws on original reporting from Medical Xpress.