BMJ supportive & palliative care · 2025
Quality of death in cancer: no treatment versus late chemotherapy in a nationwide mortality follow-back study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Nakazawa Yoko, Hamano Jun, Miyashita Mitsunori, Morita Tatsuya, Kizawa Yoshiyuki, Okumura Yasuyuki, Kawagoe Shohei, Yamamoto Hiroshi, Takeuchi Emi, Yamazaki Risa, Ogawa Asao
Аннотация
OBJECTIVES: To examine differences in quality of dying (QOD) between patients with cancer receiving no anticancer treatment (untreated group) and those receiving chemotherapy in the last 3 months of life (late chemotherapy group), and to explore socioeconomic characteristics by treatment status.
METHODS: This observational study used data from a Japanese nationwide mortality follow-back survey, restricted to cancer decedents. Questionnaires were mailed to their bereaved family members. The primary outcome was family-reported QOD, and the exploratory outcomes included symptom burden, end-of-life (EOL) discussions and socioeconomic factors. Analyses were stratified by age (<60, 60-79, ≥80 years).
RESULTS: Of 48 124 eligible responses, 12 563 were untreated. The proportion untreated increased with age (4.9%<60 years, 42.4% ≥80 years). Untreated patients had shorter survival times and more hepatobiliary or pancreatic cancer. The QOD was not poorer in untreated patients. Of untreated patients <60 years, 42.9% were free from physical distress versus 28.9% in the late chemotherapy group (difference: 14.0 points; 95% CI 5.5 to 22.5). Among untreated patients aged 60-79 years, 51.0% reported life completion versus 41.7% in the late chemotherapy group (difference: 9.3 points; 95% CI 6.9 to 11.7). More families of untreated patients reported EOL discussions with their physicians. Younger, untreated patients were more likely to be from lower-income households.
CONCLUSION: The absence of anticancer treatment was not associated with a poorer QOD in untreated patients. Socioeconomic disparities among younger patients highlight the need for equitable access to cancer care and support for value-based EOL decision-making.
METHODS: This observational study used data from a Japanese nationwide mortality follow-back survey, restricted to cancer decedents. Questionnaires were mailed to their bereaved family members. The primary outcome was family-reported QOD, and the exploratory outcomes included symptom burden, end-of-life (EOL) discussions and socioeconomic factors. Analyses were stratified by age (<60, 60-79, ≥80 years).
RESULTS: Of 48 124 eligible responses, 12 563 were untreated. The proportion untreated increased with age (4.9%<60 years, 42.4% ≥80 years). Untreated patients had shorter survival times and more hepatobiliary or pancreatic cancer. The QOD was not poorer in untreated patients. Of untreated patients <60 years, 42.9% were free from physical distress versus 28.9% in the late chemotherapy group (difference: 14.0 points; 95% CI 5.5 to 22.5). Among untreated patients aged 60-79 years, 51.0% reported life completion versus 41.7% in the late chemotherapy group (difference: 9.3 points; 95% CI 6.9 to 11.7). More families of untreated patients reported EOL discussions with their physicians. Younger, untreated patients were more likely to be from lower-income households.
CONCLUSION: The absence of anticancer treatment was not associated with a poorer QOD in untreated patients. Socioeconomic disparities among younger patients highlight the need for equitable access to cancer care and support for value-based EOL decision-making.