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A strand of papers addressing the subject of equity of provision and access to services at the end of life runs through this issue. In Brian Semensky's editorial, prompted by his grandfather's pancreatic cancer, he argues that palliative care specialists ought to be consulted early following a new diagnosis of aggressive disease in any patient. He cites a variety of reasons related to notions of rational, compassionate and equitable treatment, as well as recent studies indicating that earlier referral to palliative services improves quality of life, reduces the need for aggressive treatment and ‘may actually increase longevity.’
Matthew and Sarah-Jane Billingham's systematic review and metanalysis is my Editor's choice for this issue. Their search of peer-reviewed publications, going back to 1980, identified 26 articles that they analysed to describe congruence between preferred and actual place of death according to the presence of malignant or non-malignant disease. Pooled analysis of 7876 participants from 26 observational studies identified that a non-cancer diagnosis is associated with a statistically significant 23% increase in the incidence …
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.