2017 ASCO Annual Meeting!
Session: Patient and Survivor Care
Type: Poster Session
Time: Saturday June 3, 1:15 PM to 4:45 PM
Location: Hall A
Latino ethnicity, immigrant status, and preference for life-extending end-of-life cancer care.
Patient and Survivor Care
2017 ASCO Annual Meeting
Poster Board Number:
Poster Session (Board #17)
J Clin Oncol 35, 2017 (suppl; abstr 10028)
Author(s): Ana Isabel Tergas, Holly Gwen Prigerson, Megan Johnson Shen, Paul K Maciejewski; Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY; Weill Cornell Medical College, New York, NY
Background: Latino advanced cancer patients are less likely to engage in advance care planning, use hospice services, and receive end-of-life (EOL) care in line with their preferences compared to non-Latino advanced cancer patients. Little is known about how immigration status influences preference for life-extending care (LEC) at the EOL. Methods: Data were derived from two sequential multi-institutional, longitudinal cohort studies of patients with advanced cancer recruited from 2002 – 2008 (Coping with Cancer I [CwC-1]) and 2010 – 2015 (Coping with Cancer II [CwC-2]). Multiple logistic regression analysis was used to estimate effects of immigrant status and CwC cohort among Latinos, and effects of ethnicity and CwC cohort among US-born Latinos and non-Latino whites, on preference for LEC at the EOL. Results: Of the 760 studied cancer patients, 661 were US-born non-Latino (US non-L), 34 were US-born Latino (USL) and 65 were Latino immigrants (LI). LI were less educated (mean years of education: 7.8 years) than USL (11.1 years), who were in turn less educated than US non-L (13.7 years). Far fewer LI had insurance compared to USL (18.5% vs. 64.7%, respectively; p < 0.001), and fewer USL had insurance compared to US non-L (64.7% vs. 81.4%, respectively; p = 0.017). Within CwC-2, LI had higher odds of preferring LEC over comfort care compared to USL (adjusted odds ratio [AOR] = 9.4; 95% CI: 1.2, 72.4), and USL had lower odds of preferring LEC compared to US non-L (AOR = 0.3; 95% CI: 0.1, 1.0). LI from CwC-2 had higher odds of preferring LEC compared to LI from CwC-1 (AOR = 11.4; 95% CI: 2.7, 48.4), but there was no difference between USL from CwC-2 and USL from CwC-1. US non-L from CwC-2 had higher odds of preferring LEC compared to US non-L from CwC-1 (AOR = 3.9; 95% CI: 2.6, 5.9). Within CwC-1, there was no difference in LEC preference between LI and USL, nor between USL and US non-L. Conclusions: Immigrant status has a strong effect on preference for life-extending care among the more recent cohort of Latino cancer patients. Preference for life-extending care appears to have increased significantly over time for Latino immigrants, but remained unchanged for US-born Latinos. Latino immigrants may increasingly want life-extending care near death.