Although palliative care use has increased over time among young adults with advanced cancers in the United States, new research led by the American Cancer Society (ACS) found that utilization still remains very low. The report was presented at the 2025 ASCO Quality Care Symposium (Abstract 320).
Researchers, led by Kewei (Sylvia) Shi, MPH, of the ACS, used the National Cancer Database to identify patients aged 18 to 39 years who were newly diagnosed with stage IV cancers. Outcomes included receipt of any palliative care, specialty palliative care (eg, pain management) excluding palliative-intent treatment, and any systemic treatment. Scientists examined the associations between individual-level and facility-level characteristics (eg, safety-net burden) and each study outcome, adjusting for the year of diagnosis and state.
The study included a total of 76,666 patients. The percentage receiving any palliative care increased from 2.0% in 2010 to 4.8% in 2023. Use of systemic therapy also increased from 85.12% to 90.5%. Patients with pancreatic (7.8%), lung (6.6%), and stomach (6.3%) cancers had the highest rates of palliative care. Compared with privately insured patients, those uninsured or insured with Medicaid were more likely to receive palliative care but less likely to receive concurrent systemic treatment. Compared with patients treated at hospitals with the lowest safety-net burden, those treated at hospitals with higher safety-net burden were more likely to receive palliative care but less likely to receive systemic therapy. When compared with patients treated at community cancer programs, patients treated at National Cancer Institute–designated cancer centers were more likely to receive both palliative care and systemic therapy.
Researchers emphasized that the study highlights potential unmet needs for symptom management. It also shows targeted policies are necessary to ensure timely palliative care and comprehensive cancer care for this young, vulnerable population, especially with the increasing prevalence of early-onset cancers.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.
