Disparities in receipt of palliative treatments among disaggregated Hispanic populations with breast, lung, and prostate cancer in the United States.

Abstract

12029 Background: Despite palliative interventions’ ability to improve the quality of life and possibly improve overall survival, significant inequalities persist in uptake. Disparities in the receipt of palliative-intent interventions are characterized by broad race, socioeconomic, and geographical categories; however, less is known among disaggregated Hispanic populations. We examine disparities among Hispanic subgroups in receipt of palliative-intent interventions among disaggregated Hispanic patients with stage IV lung, breast, and prostate cancer. Methods: Using the National Cancer Database (NCDB), we collected data on the receipt of palliative-intent interventions (including radiotherapy, chemotherapy, and/or other pain management therapy) among Hispanic subgroups diagnosed with AJCC analytic stage IV breast, lung, and prostate cancer between 2004 and 2021. Multivariate linear regressions (adjusting for age group, country of origin, year group, sex, insurance status, 2016 median income quartiles, facility type, CDCC Score, and facility location) were conducted for each cancer type to quantify the disparities in uptake of palliative-intent interventions among Hispanic subgroups. Results: Among 945,894 total patients, disaggregated analyses revealed reduced receipt of palliative-intent interventions for lung, breast, and prostate cancer patients of Mexican descent (Lung AOR 0.74, [0.67-0.81], P<0.001; Breast AOR 0.69, [0.58-0.82], P<0.001; Prostate AOR 0.82, [0.69-0.99], P=0.03) compared to non-Hispanic white patients. Receipt of palliative-intent interventions for patients of South or Central American descent and Cuban descent were also reduced in comparison to White patients for lung and breast tumors. Reuptake of palliative-intent interventions for breast cancer was significantly reduced for patients of Dominican Republic descent compared with non-Hispanic white patients (AOR 0.65, [0.43-1.00], P=0.05). Conclusions: Our findings expose that disparities exist in the receipt of palliative-intent interventions among Hispanic subgroups upon disaggregation. We highlight the need for research to characterize such disparities and discuss community-level and patient-centric solutions to address their drivers. Palliative-intent treatment receipt stratified by subgroup and tumor type. Race % Lung Tumor % Breast Tumor % Prostate Tumor Non-Hispanic White 26.4 21.7 12.1 Mexican 16.7 12.7 8.8 Puerto Rican 27.8 22.7 17.0 Cuban 19.2 17.0 11.4 South/Central American 21.5 15.0 11.5 Other Specified Spanish/Hispanic origin 28.2 23.0 10.2 NOS 19.5 17.0 10.9 Spanish surname 16.6 910.0 9.9 Dominican Republic 30.0 19.0 12.7 Non-Hispanic other 24.4 19.9 12.1