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Changes in the treatment rate of patients newly diagnosed with stage IV cancer near the end of life from 2012 to 2017 in Korea
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Kyuwoong Kim, Hyun Jung Jho, So Jung Park, Bohyun Park, Jin Young Choi
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Epidemiol Health. 2023;45:e2023021. Published online February 14, 2023
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DOI: https://doi.org/10.4178/epih.e2023021
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Abstract
OBJECTIVES
This study aimed to evaluate changes in the cancer treatment rate among patients newly diagnosed with stage IV cancer using socio-demographic and clinical subgroups in a nationwide cohort of Korean patients.
METHODS This retrospective, national-level study used the Korea Central Cancer Registry (KCCR), which is linked to the National Health Insurance Service (NHIS) database, from January 1, 2012 to December 31, 2017. The records of patients newly diagnosed with stage IV of the 5 cancers with the highest cancer-related mortality rate were identified to analyze changes in the treatment rate. The main outcome examined in this study was the change in the cancer treatment rate between 2012 and 2017, as measured using the annual percent change (APC).
RESULTS A total of 106,082 patients with newly diagnosed gastric, colorectal, liver, pancreatic, and lung cancers at the end of life (EoL) were identified from the KCCR-NHIS database. Of these patients, 76,533 (72.1%) received cancer treatment. Over the study period (2012-2017), the proportion of patients who received cancer treatment at EoL decreased by 8.3%, with an APC of -2.1% (95% confidence interval, -2.6 to -1.6). This declining trend of cancer treatment among patients with advanced cancer stage at EoL was consistent among socio-demographic and clinical subgroups.
CONCLUSIONS The proportion of untreated patients with stage IV cancer is increasing in the Korea. For patients who are not undergoing standard cancer treatment near EoL, an alternative care plan, such as early palliative care, should be considered.
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Summary
Korean summary
국민건강보험공단과 중앙암등록본부 자료를 활용하여 4기 암환자의 암 치료 비율 추이를 분석한 결과 2012년부터 2017년까지 위암, 대장암, 간암, 췌장암, 폐암으로 진단받은 4기 암환자들의 암 치료 비율의 연간비율변화는 8.3% 감소하는 것으로 나타났다. 이러한 결과는 인구사회학적 및 임상적 특성에 관계없이 일관되었다. 본 연구결과는 말기에 가까운 4기 암 환자들이 표준 치료를 받지 못하는 경우, 조기 완화의료와 같은 대안적인 계획을 고려할 필요가 있음을 시사한다.
Key Message
● Between 2012 and 2017, there was a significant decrease in the treatment rate among these patients, though most still received cancer treatment.
● Alternative clinical choices, such as the early utilization of hospice and palliative care, may improve quality of life and reduce the need for aggressive care for such patients.
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The National Hospice and Palliative Care registry in Korea
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Kyuwoong Kim, Bohyun Park, Bonju Gu, Eun Jeong Nam, Sue Hyun Kye, Jin Young Choi
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Epidemiol Health. 2022;44:e2022079. Published online September 21, 2022
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DOI: https://doi.org/10.4178/epih.e2022079
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Abstract
The National Hospice and Palliative Care (NHPC) registry is a nationwide database in Korea that systematically collects information on terminally ill cancer patients receiving inpatient hospice care. From 2018 to 2020, a total of 47,911 patients were enrolled in the NHPC registry from hospitals providing inpatient hospice care. The NHPC database mainly contains the socio-demographic and clinical information of the registered patients. Among these patients, approximately 75% were 60 years or older, and the ratio of males to females was 1:1.41. Lung, liver, colorectal, pancreatic, and gastric cancer made up nearly 90% of the cancer sites among the registered patients. Upon their initial admission to the hospice ward, around 80% of the patients were aware of their terminal illness. About half of the patients had mild pain at the time of the initial admission to the hospice ward, and the duration of hospice care was 14 days (interquartile range, 6-30) in 2019 and 2020. The NHPC registry aims to provide national statistics on inpatient hospice care to assist health policy-making.
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Summary
Korean summary
본 논문에서 소개된 국가 호스피스·완화의료 등록시스템은 국내 입원형 호스피스 환자의 인구사회학적 특성과 임상정보에 관한 정보를 포함하고 있습니다. 등록시스템은 국내 호스피스·완화의료 현황에 대한 국가통계 생산, 근거기반 호스피스·완화의료 정책 개발 및 연구 등에 활용될 수 있습니다.
Key Message
The National Hospice and Palliative Care registry contains information on demographics and clinical information of patients receiving inpatient hospice care in Korea. Along with its primary purpose to provide national statistics on the current status of hospice care in the country, the registry could also be used for evidence-based health policy or research pertaining to hospice in Korea.
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Citations
Citations to this article as recorded by  - For the Universal Right to Access Quality End-of-Life Care in Korea: Broadening Our Perspective After the 2018 Life-Sustaining Treatment Decisions Act
Hye Yoon Park, Min Sun Kim, Shin Hye Yoo, Jung Lee, In Gyu Song, So Yeon Jeon, Eun Kyung Choi
Journal of Korean Medical Science.2024;[Epub] CrossRef - Advance Care Planning in South Korea
Yu Jung Kim, Sun-Hyun Kim
Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen.2023; 180: 68. CrossRef - Changes in the Place of Death of Patients With Cancer After the Introduction of Insurance-Covered, Home-Based Hospice Care in Korea
Il Yun, Sung-In Jang, Eun-Cheol Park, Suk-Yong Jang
JAMA Network Open.2023; 6(11): e2341422. CrossRef - Application of Acceptance and Commitment Therapy (ACT) in Hospice and Palliative Care Settings
So-Young Park
The Journal of Hospice and Palliative Care.2023; 26(3): 140. CrossRef
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