Abstract
ABSTRACTOBJECTIVE Investigate factors associated with death at home among older adults who died of cancer in a large city.METHODS This is a descriptive study, including all cancer deaths (ICD C00-C97) occurring between 2006 and 2012, among residents of the city of São Paulo, 60 years of age or older. The data source was the Mortality Information System, and the proportion of deaths was calculated according to place of occurrence, gender, age, race/skin color, education, marital status, cancer type, hospital bed availability, and year of death. The chi-squared test was used to examine the associations between the place of death and sociodemographic and clinical variables. Logistic regression was used to identify factors associated with home death. Crude and adjusted odds ratios and the corresponding 95% confidence intervals were estimated.RESULTS Most of the deaths occurred in hospitals (88.2%). There was a significant association between the place of death and the following variables: gender, race/skin color, education, age, marital status, cancer type, hospital bed availability, and year of death. In the multivariate analysis, all variables, except the availability of hospital beds, remained as independent predictors of death at home.CONCLUSIONS There was a predominance of hospital deaths, with an increase in frequency in the period. Female gender, higher education, married or widowed status, and black race were associated with a decreased risk of death at home, while increasing age, Asian race, and solid neoplasms were associated with higher risk of dying at home.
Highlights
Population aging is a global phenomenon, occurring in developed countries and in developing countries
There was a predominance of hospital deaths, with an increase in frequency in the period
Higher education, married or widowed status, and black race were associated with a decreased risk of death at home, while increasing age, Asian race, and solid neoplasms were associated with higher risk of dying at home
Summary
Population aging is a global phenomenon, occurring in developed countries and in developing countries. In Brazil, for the year 2016, an estimated 600,000 new cases of cancer were estimated for both genders[3], and 196,954 deaths from the disease were recorded in 20134. While about 59% of new cases registered in Brazil affect individuals over 60 years of age[5], more than two-thirds of deaths are recorded in older adults[4]. The city of São Paulo has high of cancer incidence rates (293.2 and 208.3/100,000 inhabitants, adjusted rates for the world population, all neoplasms except skin)[5] and neoplasms were the second cause of death among older adults residents in the city (20.7%), surpassed only by diseases of the circulatory system[4]
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