Disparities in palliative care settings among patients with renal cell carcinoma in the United States: a nationwide population-based study

Department

Internal Medicine

Additional Department

Oncology and Hematology

Document Type

Article

Publication Title

Palliative Medicine in Practice

Abstract

Background: Place of death (PoD) is a key indicator of end-of-life (EOL) care quality, yet national PoD patterns among renal cell carcinoma (RCC) decedents remain poorly characterized.

Methods: Using the CDC WONDER Multiple Cause of Death database, we identified RCC decedents from 1999 to 2023. Temporal trends in PoD were assessed by linear regression. Multivariate logistic regression estimated adjusted odds ratios (aOR) for home, hospice, and nursing home/long-term care deaths versus medical facility deaths, adjusting for age, sex, race, ethnicity, urbanization, and census region.

Results: Among 329,918 RCC decedents, hospice facility deaths increased from 0.6% in 2003 to 12.2% in 2023, while medical facility deaths declined from 34.2% to 25.3% and nursing home/long-term care deaths from 17.9% to 11.8% (all p < 0.001). Compared with White decedents, Black decedents had lower odds of home (aOR 0.54; 95% CI 0.52–0.55), hospice (aOR 0.78; 95% CI 0.74–0.82), and nursing home/long-term care deaths (aOR 0.5; 95% CI 0.48–0.52). Hispanic decedents had higher odds of home deaths (aOR 1.14; 95% CI 1.11–1.17) but lower hospice (aOR 0.77; 95% CI 0.73–0.81) and nursing home/long-term care deaths (aOR 0.51; 95% CI 0.48–0.53) than non-Hispanic decedents. Non-metropolitan residents were less than half as likely as large-metropolitan residents to die in a hospice facility (aOR 0.44; 95% CI 0.42–0.46).

Conclusions: Place of death among RCC decedents has shifted toward hospice over the past two decades, but significant racial, ethnic, and rural disparities persist, underscoring the need for interventions to improve equitable access to community-based EOL care.

First Page

e01326053

DOI

10.5603/pmp.112649

Volume

20

Publication Date

7-6-2026

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