Disparities in Receipt of Palliative Intent Interventions Across Disaggregated Hispanic Subgroups with Late-Stage Colon Cancer in the United States CO-AUTHORS

INTRODUCTION Palliative interventions, defined as cancer-directed therapies with palliative intent, improve the quality of life and alleviate suffering for patients with advanced colon cancer. Limited research examines disparities in palliative-intent receipt across disaggregated Hispanic subgroups. We analyzed palliative intervention receipt among Hispanic patients with stage IV colon cancer. METHODS Using the National Cancer Database, we retrospectively analyzed adults diagnosed with stage IV colon cancer (2004–2021) with known palliative intervention receipt status (defined binarily). We performed logistic regressions to characterize palliative intervention receipt rates across a) broad racial groups and b) country of origin, relative to Non-Hispanic White patients (alpha < 0.05). Regressions included a race*year interaction term to examine changes in palliative intervention receipt over time (alpha < 0.1). RESULTS We analyzed 202,073 patients; 12.94% (N = 26,142) received palliative interventions. Hispanic Black patients were 0.55 times as likely (P = 0.030) to receive palliative interventions as non-Hispanic White patients. Multivariable regression revealed significantly lower odds of palliative intervention receipt among several Hispanic subgroups: Puerto Rican patients were 24% less likely (P = 0.040), Cuban patients 30% less likely (P = 0.030), and patients of Hispanic Not Otherwise Specified (NOS) origin were 13% less likely (P < 0.001) to receive care compared to non-Hispanic White patients. When disaggregated by year of diagnosis, a significant time*race interaction was observed for Dominican patients, who were 58% less likely (AOR = 0.42, P = 0.020) to receive palliative care in 2013–2021 compared to 2004–2012, relative to non-Hispanic White patients. These findings highlight persistent and subgroup-specific disparities in the receipt of palliative-intent care among patients with stage IV colon cancer. DISCUSSION Hispanic Black, Puerto Rican, and Cuban patients experienced lower receipt of palliative interventions, revealing disparities in access to equitable cancer-directed end-of-life care. Culturally tailored efforts should be made to expand palliative intervention access for diverse racial/ethnic groups.