4.7 Article

Deaths from hepatocellular carcinoma are more likely to occur in medical facilities than deaths from other cancers: 2003-2018

Journal

LIVER INTERNATIONAL
Volume 41, Issue 7, Pages 1489-1493

Publisher

WILEY
DOI: 10.1111/liv.14915

Keywords

hepatocellular carcinoma; palliative care; place of death; terminal care

Funding

  1. National Heart, Lung and Blood Institute at the National Institutes of Health [K23 HL136891]
  2. National Institutes of Health [P30AG059988, P30DK092939]
  3. American Heart Association [19TPA34890060]

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The analysis of US death certificate data from 2003 to 2018 showed that the proportion of deaths in hospice facilities increased significantly for patients with HCC, but did not change at home. Individuals with HCC were more likely to die in medical facilities and less likely to die at home compared to those with non-HCC cancer.
Place of death is a key indicator of quality of end-of-life care, and most people with a terminal diagnosis prefer to die at home. Home has surpassed the hospital as the most common location of all-cause and total cancer-related deaths in the United States. However, trends in place of death due to hepatocellular carcinoma (HCC), which is uniquely comanaged by hepatologists and oncologists, have not been described. We analysed US death certificate data from 2003 to 2018 for the proportion of deaths over time at medical facilities, nursing facilities, hospice facilities and home, for HCC and non-HCC cancer. The proportion of deaths increased from 0.6% to 15.2% in hospice facilities (P trend < 0.0001) but did not change at home. In multivariable analysis, persons with HCC were more likely than persons with non-HCC cancer to die in medical facilities, while persons with HCC were less likely to die at home.

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