Journal of Palliative Medicine
Volume 22, Issue 7, 2019, Pages 833-837

Latino Ethnicity, Immigrant Status, and Preference for End-of-Life Cancer Care (Article)

Tergas A.I. , Prigerson H.G. , Shen M.J. , Bates L.M. , Neugut A.I. , Wright J.D. , Maciejewski P.K.*
  • a Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surg., New York, NY, United States, Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surg., New York, NY, United States, New York Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY, United States, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States, Cornell Center for Research on End-of-Life Care, Weill Cornell Medicine, 525 East 68th Street, Box 39, New York, NY 10065, United States
  • b Cornell Center for Research on End-of-Life Care, Weill Cornell Medicine, 525 East 68th Street, Box 39, New York, NY 10065, United States, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
  • c Cornell Center for Research on End-of-Life Care, Weill Cornell Medicine, 525 East 68th Street, Box 39, New York, NY 10065, United States, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
  • d Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
  • e Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surg., New York, NY, United States, New York Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY, United States, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States, Department of Medicine, Columbia University College of Physicians and Surg., New York, NY, United States
  • f Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surg., New York, NY, United States, Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surg., New York, NY, United States, New York Presbyterian Hospital, Columbia University Irving Medical Center, New York, NY, United States
  • g Cornell Center for Research on End-of-Life Care, Weill Cornell Medicine, 525 East 68th Street, Box 39, New York, NY 10065, United States, Department of Medicine, Weill Cornell Medicine, New York, NY, United States, Department of Radiology, Weill Cornell Medicine, New York, NY, United States

Abstract

Background: Little is known about how immigration status influences preference for life-extending care (LEC) at the end of life (EoL). Objective: The purpose was to determine how preference for LEC at the EoL for advanced cancer patients varied by Latino ethnicity and immigrant status, and over time between two large cohorts. Methods: Data were derived from two sequential multi-institutional, longitudinal cohort studies of advanced cancer patients, recruited from 2002 to 2008 (coping with cancer I [CwC-1]) and 2010 to 2015 (coping with cancer II [CwC-2]). Self-reported U.S.-born whites (whites) (N = 253), U.S.-born Latinos (US-L) (N = 34), and Latino immigrants (LI) (N = 65) with a poor-prognosis cancer were included. The primary independent variables were immigrant status, Latino ethnicity, and CwC cohort. The primary dependent variable was preference for LEC. Results: Within CwC-2, LI were 9.4 times more likely to prefer LEC over comfort care versus US-L (adjusted odds ratio [AOR] = 9.4; 95% confidence interval [CI]: 1.2-72.4), and US-L were 0.3 times less likely to prefer LEC versus whites (AOR = 0.3; 95% CI: 0.1-1.0). LI from CwC-2 were 11.4 times more likely to prefer LEC versus LI from CwC-1 (AOR = 11.4; 95% CI: 2.7-48.4). Within CwC-1, there was no difference in LEC preference between LI and US-L, nor between US-L and whites. Conclusions: Immigrant status had a strong effect on preference for LEC at the EoL among the more recent cohort of Latino cancer patients. Preference for LEC appears to have increased significantly over time for LI but remained unchanged for US-L. LI may increasingly want LEC near death. Copyright © 2019, Mary Ann Liebert, Inc.

Author Keywords

immigrant status Latino cancer disparities

Index Keywords

male human female major clinical study Terminal Care cohort analysis patient comfort cancer patient ethnicity Caucasian Article middle aged immigration adult advanced cancer Self Report Hispanic
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85068342975&doi=10.1089%2fjpm.2018.0537&partnerID=40&md5=5758ae6b47a9bac89e4a616619567d36
DOI: 10.1089/jpm.2018.0537
ISSN: 10966218
Original Language: English