{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:02:23Z","timestamp":1777384943795,"version":"3.51.4"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chemotherapy at the end of life may not extend survival and can diminish quality of life. Understanding patterns of use is critical to ensuring equitable, patient-centered care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine racial and ethnic disparities in chemotherapy receipt within 30\u00a0days of death among patients with colon cancer, and whether these disparities changed over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the National Cancer Database, identifying patients with colon cancer who died within 30\u00a0days between 2004 and 2021. The final sample included 43\u00a0490 patients. The primary outcome was chemotherapy receipt within 30\u00a0days of death. Multivariable logistic regression adjusted for demographics, insurance, comorbidities, facility characteristics, and socioeconomic factors. A difference-in-differences approach compared 2 periods: 2004-2012 and 2013-2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 43\u00a0490 patients (mean age, 75.6 years; 51.1% female), 1275 (2.9%) received chemotherapy near death. Adjusted analyses found no statistically significant racial or ethnic differences in use. However, Asian American patients had a marginally increased likelihood of receiving chemotherapy over time compared with non-Hispanic White patients (interaction OR, 2.25; 95% CI, 0.95-5.32;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .065). Older age (\u226580\u00a0years: OR, 0.12), higher comorbidity burden (Charlson-Deyo score \u22652: OR, 0.61), and uninsured status were associated with lower odds of treatment. Private insurance (OR, 1.67) and treatment at comprehensive cancer centers were associated with higher odds.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While overt racial disparities were not observed, disparities by insurance and facility type point to structural inequities that should be addressed in future quality improvement efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091261422382","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T07:46:43Z","timestamp":1769845603000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Chemotherapy at the End of Life in Colon Cancer Patients"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2692-8195","authenticated-orcid":false,"given":"Rushabh H.","family":"Doshi","sequence":"first","affiliation":[{"name":"Yale School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khushi","family":"Kohli","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Harvard University, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5615-7289","authenticated-orcid":false,"given":"Tenzin","family":"Dhondup","sequence":"additional","affiliation":[{"name":"Yale School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8248-9116","authenticated-orcid":false,"given":"Siona","family":"Mishra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asher","family":"Shin","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhav","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thiruvengadam","family":"Muniraj","sequence":"additional","affiliation":[{"name":"Yale School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward Christopher","family":"Dee","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6603498"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-022-00910-x"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-020-01580-0"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2008.587"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2007.15.8253"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i24.7602"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol31030092"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdw654"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.epi-20-1728"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1200\/jco.23.02186"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25395"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-024-16577-y"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.5114\/ait.2022.119124"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0044-1786393"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.30313"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2014.08.013"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21772"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.3390\/diseases12040079"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-018-0339-8"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1219"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11912-024-01617-3"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-07213-1"},{"key":"e_1_3_5_24_2","unstructured":"Participant User Files. 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