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Original research
Palliative treatment disparities in metastatic colon cancer: US retrospective cohort study with disaggregated ethnic groups
  1. Sruthi Ranganathan1,
  2. Alessandro Hammond2,
  3. Urvish Jain3,
  4. Khushi Kohli2,
  5. Nishwant Swami4,
  6. Tej A Patel5,
  7. Erin Jay G Feliciano6,
  8. Paul L Nguyen7,
  9. Kenrick Ng8,
  10. Edward Christopher Dee9 and
  11. Bhav Jain10
  1. 1University of Cambridge Clinical School, Cambridge, UK
  2. 2Harvard University, Cambridge, Massachusetts, USA
  3. 3University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  4. 4Department of Internal Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
  5. 5Department of Healthcare Management & Policy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  6. 6Department of Medicine, NYC Health + Hospitals/Elmhurst, Elmhurst, New York, USA
  7. 7Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
  8. 8Department of Medical Oncology, St Bartholomew’s Hospital, London, England, UK
  9. 9Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
  10. 10Stanford University School of Medicine, Stanford University, Stanford, CA, USA
  1. Correspondence to Bhav Jain; bhavjain{at}stanford.edu

Abstract

Background Palliative care is important in addressing the needs of patients and their caregivers holistically, particularly where patients are diagnosed with an advanced cancer such as metastatic colon cancer. Racial or ethnic disparities in the receipt of palliative treatment have not been well studied.

Methods Data from the National Cancer Database were used to identify patients with metastatic colon cancer. Patients were categorised into one of the following racial or ethnic groups: White, Black, Southeast Asian, East Asian, South Asian, Native Hawaiian or Other Pacific Islander (NHPI), other Asian and American Indian, Aleutian or Eskimo. The dependent variable was the receipt of palliative treatment, while the independent variable was the patients’ racial or ethnic group. Multivariable logistic regressions were performed to derive the adjusted ORs (AOR) and p values.

Results Relative to White patients, patients who identified as Black, Southeast Asian or other Asian were less likely to receive palliative treatment (Black AOR=0.944, 95% CI 0.905 to 0.985, p=0.008; Southeast Asians AOR=0.678, 95% CI 0.553 to 0.830, p<0.001; other Asian AOR=0.781, 95% CI 0.637 to 0.957, p=0.017). However, NHPI patients had greater odds of receiving palliative treatment (NHPI AOR=1.696, 95% CI 1.267 to 2.271, p<0.001).

Conclusions Black, Southeast Asian or other Asian patients had decreased odds of receiving palliative treatment, while NHPI patients had greater odds of receiving palliative treatment, compared with White patients. Further studies are needed to disaggregate reasons behind these disparities in the receipt of palliative treatment.

  • palliative care

Data availability statement

Data are available on reasonable request. Data may be obtained from a third party and are not publicly available. Data are available on reasonable request, and is not publicly accessible.

https://doi.org/10.1136/spcare-2025-005478

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    Data availability statement

    Data are available on reasonable request. Data may be obtained from a third party and are not publicly available. Data are available on reasonable request, and is not publicly accessible.

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    Footnotes

    • X @EChrisDee, @@BhavJain_

    • SR and AH contributed equally.

    • Contributors SR, ECD and BJ planned the study. SR performed the data analysis. SR, ECD, AH and BJ drafted the initial manuscript. UJ, KK, NS, TAP, EJF, PN, KN edited the manuscript. All authors contributed to the final manuscript. ECD is the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.