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Accuracy of Advanced Cancer Patients' Life Expectancy Estimates: The Role of Race and Source of Life Expectancy Information

Principal Investigators: 
Dr. Kelly Trevino
Sponsored by: 
American Cancer Society
Research Description: 

Racial and ethnic disparities are multifaceted and come in many different forms. The conversation only grows more relevant as our nation shifts to embracing more diversity and inclusion. Our communities are becoming more and more diverse and it is important to identify, address and develop solutions for racial and ethnic disparities in health care, and in particular, end-stage cancer care.

Assistant Professor in Psychology in Medicine, Dr. Kelly Trevino et. al. performed a study aimed to examine the source of advanced cancer patients’ information about their prognosis in hopes of determining whether this source of information could explain racial disparities in the accuracy of patients’ life expectancy estimates (LEEs).

Studying 229 patients; 31 black and 198 white, only 39.30% of patients estimated their life expectancy within 12 months of their actual survival, only 18.3% reported that a medical provider was the source of their expectancy estimates. Interestingly however, out of that sample, none of the black patients (0%) based an estimate on a medical provider. Perhaps as a consequence, black patients were more likely to have an inaccurate LEE than white patients. Even after the analysis had been controlled for sociodemographic characteristics and the source of the LEEs, being black remained the significant predictor of an inaccurate LEE.

The bottom line is that the majority of advanced cancer patients have an inaccurate understanding of their life expectancy which has real implications. This is important because a realistic understanding of life expectancy influences EoL care goals and treatment decision-making, as well as how one spends his or her remaining months and days with their loved ones. It is disconcerting how infrequently medical providers are used as a reference point to make these estimates. The reference point or source of LEEs does not explain racial differences in estimate accuracy, however. These results point to the need for addressing ways to improve advanced care patients’ illness understanding across racial divides.

Research Type: 
Weill Cornell