Prognostic Understanding Affects Hospitalization, Hospice Use

For older patients with advanced cancer, poor prognostic understanding of the curability of their disease may affect their hospitalizations or use of hospice, according to a study that was presented during the 2021 ASCO Annual Meeting.

Data were collected on 541 patients aged ≥70 with incurable solid tumor or lymphoma considering any line of cancer treatment. Both patients and their oncologists were asked what they believed the odds of their cancer being cured was (options: 100%, > 50%, 50/50, < 50%, 0%, and uncertain) and estimates of patient’s survival (options: 0-6 months, 7-12 months, 1-2 years, 2-5 years, and > 5 years). Non-0% options were deemed “poor understanding of curability” and survival estimate >5 years was considered poor understanding of survival estimates; any difference in response choices was deemed discordant.

Overall, 59% of patients had poor prognostic understanding of curability, and 41% had poor understanding of survival estimates. About 60% and 72% of patient-oncologist pairs, respectively, were discordant regarding curability and survival prognostic understanding. Correlations were observed between poor prognostic understanding of survival estimates and lower odds of hospice use, as well as discordance in survival estimates and higher odds of hospitalization.

“Prognostic understanding may be associated with hospitalization or hospice use depending on how patients were queried about their prognosis and whether oncologists’ estimates were considered,” the study authors concluded.