Specialist Palliative Care in Young Adults With Cancer: A 10-Year Retrospective Cohort Study.
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ContextYoung adults with cancer have distinct palliative care needs, but data on referral patterns and end-of-life outcomes are limited.ObjectivesDescribe characteristics, timing of palliative care involvement, symptom burden, and place of death among young adult oncologic patients.MethodsRetrospective cohort study of patients aged 18-39 years with cancer followed by a palliative care team between 2014 and 2024. Data were obtained from electronic medical records. Variables were summarized as mean ± SD, median (IQR), or frequency (%), as appropriate. Groups were compared using chi-square/Fisher's exact and Mann-Whitney U tests, with P < 0.05 considered significant. A Bonferroni correction was applied.ResultsThirty-seven patients were included (35.9 ± 4.1 years; 56.8% female). Most were married (43.2%) and 59.5% had children. The most common cancers were breast, lung, colorectal, and esophagogastric. First palliative care assessment occurred mainly during hospitalization (51.4%), and rarely at home (10.8%). Median time from diagnosis to first assessment was 196.0 days, and from first assessment to death 98.0 days. At first assessment, 40.5% were asymptomatic; pain and gastrointestinal symptoms were the most frequent symptoms. Psychological support was provided to 40.5% and palliative sedation to 32.4%. Most patients died outside the home (62.2%). Women more often served as primary caregivers (71.4%), and the diagnosis-to-first-assessment interval differed by place of death. None of the exploratory comparisons by sex or place of death remained statistically significant.ConclusionIn this cohort initial palliative care assessments occurred predominantly during hospitalization and most deaths occurred outside the home. Early referral can improve young adults with cancer needs.