Where do adults with pancreatic cancer die in the United States: A retrospective analysis of 25 years.

Abstract

e24042 Background: Pancreatic cancer remains a leading cause of cancer-related morbidity and mortality. With limited survival for many patients, end-of-life care is a critical component of pancreatic cancer management. Despite the emphasis on palliative care, information regarding where adults with pancreatic cancer spend their final days remains largely unexplored. This study aimed to analyze the location and circumstances of death among adults with pancreatic cancer in the United States using publicly available data from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiological Research (CDC WONDER). Methods: Mortality data of individuals with pancreatic cancer aged > 25 years was obtained from CDC WONDER and analyzed from 1999 to 2023. The places of death were categorized as the medical facility, descendants’ home, hospice facility, nursing homes/long-term care facility. Results: A total of 956,029 deaths were reported in individuals with pancreatic cancer aged > 25 years from 1999 to 2023. Pancreatic cancer-related age-adjusted mortality rates per 100,000 increased from 1999 (16.41) to 2023 (17.17). Descendants' homes experience the greatest number of deaths (49.21%, 470,448) from 1999 to 2023. Deaths at home nearly doubled, rising from 1.37% in 1999 (13,139) to 2.77% in 2023 (26,464). Medical facility deaths increased from 1.04% in 1999 (9,903) to 1.12% in 2023 (10,731). Deaths at hospice facilities increased from 0.02% in 2003 (214) to 0.66% in 2023 (6,267). Similarly, deaths at other locations increased from 0.19% (1,781) in 1999 to 0.23% (2,204) in 2023 Deaths in nursing homes/long-term care declined from 0.44% in 1999 (4245) to 0.39% in 2023 (3,769). Unknown locations accounted for a total of 2050 deaths. Conclusions: This study highlights the changing patterns in the places of death among patients with pancreatic cancer, with the most deaths occurring at descendants' homes and a twofold increase in pancreatic cancer-related deaths occurring at home over the past two decades. Further research is needed to determine the end-of-life needs and preferences of these patients and their care-takers and identify the basis of these disparities. Place of death Years Deaths (n) % of total Decedent’s home 1999–2023 470,448 49.21 Medical facility 1999–2023 232,458 24.31 Nursing home/LTC 1999–2023 107,265 11.22 Hospice facility 2003–2023 90,745 9.49 Other/Unknown 1999–2023 55,113 5.77 Total 1999–2023 956,029 100