Disparities in Palliative Treatment Utilization in Metastatic Colorectal Cancer Patients

Patients with metastatic colorectal cancer (mCRC) often require multidisciplinary interventions due to the diversity of symptoms. Palliative treatment offers benefits including improved quality of life, yet sociodemographic disparities influence its utilization. This study aims to characterize these disparities in palliative treatment use among mCRC patients.

Utilizing data from the National Cancer Database, we identified patients diagnosed with mCRC between 2016 and 2020. Patients were categorized by metastatic site: peritoneal, liver, lung, or bone/brain/lymph node. Palliative treatment rates were compared across metastatic sites as well as patient and hospital factors.

A total of 106,241 patients were identified as having mCRC, with 19,208 (18.08%) receiving palliative treatment; 24.0% of patients with multiple metastatic disease and 14.0% of those with solely peritoneal metastases (PM) utilized palliative treatment (p < 0.001). Furthermore, patients over 75 years of age had a significantly decreased likelihood of receiving palliative treatment compared with younger patients (p = 0.0002). Hispanic patients did not differ significantly from non-Hispanic White populations (p = 0.47). Those in the highest education quartile demonstrated a higher degree of palliative treatment use compared with the lowest education quartile (p = 0.0081).

Among patients with mCRC, those with multiple sites of metastatic disease tend to receive higher rates of palliative treatment compared with those with oligometastatic disease. Patients with PM had the lowest rate of receiving palliative treatment. Other determinates of utilizing palliative treatment include younger age groups and higher education. Further research is warranted to understand the patterns of disparities in palliative treatment use among mCRC patients.