Disparities in the Receipt of Palliative-intent Treatment Across Disaggregated Hispanic Subgroups With Stage IV...

Gastric cancer affects over 30,000 Americans annually and has a 5-year survival rate of roughly 40%. Palliative-intent interventions are critical for symptom relief and quality of life, yet access remains inequitable. We examined disparities in receipt of palliative-intent care among disaggregated Hispanic subgroups with gastric cancer.

Using the National Cancer Database (2004 to 2021), we identified adults (≥18 y) with AJCC stage IV gastric cancer. The primary outcome was receipt of palliative-intent intervention, defined as treatment for symptom alleviation rather than cure. Patients were stratified into Hispanic subgroups (Mexican, Puerto Rican, Cuban, South/Central American, Dominican, Other Hispanic, Not Otherwise Specified [NOS], and Spanish surname only) and compared with non-Hispanic White patients. Multivariable logistic regression adjusted for demographic, socioeconomic, and clinical covariates.

Among 73,990 patients (median age 67 y), 65.2% were non-Hispanic White. Only 19.3% received palliative-intent treatment. Compared with non-Hispanic White patients, odds of receipt were lower for Mexican (AOR 0.74, 95% CI: 0.64-0.87), Cuban (AOR 0.57, 95% CI: 0.34-0.94), South/Central American (AOR 0.73, 95% CI: 0.61-0.88), and NOS Hispanic (AOR 0.82, 95% CI: 0.75-0.89) patients (all P <0.05).

Several Hispanic subgroups experience significantly lower odds of receiving palliative-intent care for metastatic gastric cancer. These inequities likely reflect intersecting socioeconomic, linguistic, and structural barriers. Advancing equity will require culturally responsive communication, improved language access, and systemic reform in end-of-life care delivery.