Trends and Disparities in Location of Death Among Patients With Pancreatic Cancer

PURPOSE Pancreatic cancer is one of the most lethal cancers in the United States. Many patients with pancreatic cancer ultimately require end-of-life (EOL) care, which encompasses various aspects, including location of death. This study aims to evaluate trends and disparities in location of death among patients with pancreatic cancer across demographics. PATIENTS AND METHODS This retrospective study used death certificate data from Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research (2003-2020) to assess trends in location of death for patients with pancreatic cancer 35 years and older in the United States. We used linear regression to evaluate temporal trends in the location of death across the years. All analyses were performed using Microsoft Excel's Data Analysis Toolpak. Odds ratios (ORs) were calculated using the 2 × 2 contingency table. RESULTS From 2003 to 2020, 690,950 pancreatic cancer deaths occurred in the United States. Most deaths occurred at home (48.52%), followed by medical facilities (23.58%), nursing homes (11.49%), hospice facilities (10.56%), and other locations (5.85%). Hospice facility deaths increased significantly (0.70% to 11.85%, P < .01), as did home deaths (46.53% to 58.01%, P < .01). Medical facility and nursing home deaths decreased ( P < .01). Significant upward trends in hospice facility deaths were also observed across racial groups: White patients increased from 0.52% to 9.46% ( P < .01), African American patients from 0.07% to 1.45% ( P < .01), and Hispanic patients from 0.06% to 0.62% ( P < .01). Asian American, Hispanic, and African American patients had lower odds of dying in hospice facilities (OR, 0.66, 0.84, and 0.97, respectively) compared with White patients. CONCLUSION From 2003 to 2020, there was a shift toward hospice and home deaths, but racial and ethnic disparities remain. These findings underscore the need to address disparities in EOL care.