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Age, cancer site and gender associations with symptoms and problems in specialised palliative care: a large, nationwide, register-based study
  1. Maiken Bang Hansen1,2,
  2. Lone Ross2,
  3. Morten Aagaard Petersen2 and
  4. Mogens Groenvold1,2
  1. 1Department of Public Health, Københavns Universitet, Kobenhavns, Denmark
  2. 2The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, Kobenhavn, Denmark
  1. Correspondence to Maiken Bang Hansen, Bispebjerg Hospital, Kobenhavn 2400, Denmark; maiken.bang.hansen{at}


Background Patients referred to specialised palliative care are troubled by symptoms/problems, but more knowledge is needed on the level and frequency of symptoms/problems. It is also uncertain how gender, age and cancer diagnosis, respectively, are associated with symptoms/problems.

Aims To describe symptoms/problems in patients with cancer at the start of specialised palliative care, and to study how age, gender and cancer diagnosis were associated with symptoms/problems.

Design A register-based study including data from the Danish Palliative Care Database.

Setting/Participants Patients with cancer who reported their symptoms/problems using the European Organisation for Research and Treatment of Cancer Quality of Life Questionaire-Core-15-Palliative Care (EORTC QLQ-C15-PAL) at the start of specialised palliative care were included. Ordinal logistic regression was performed to test if gender, age and cancer diagnosis were associated with each symptom/problem.

Results 31 771 patients with cancer were included in the study. The most prevalent and severe symptoms/problems were pain, appetite loss, fatigue, poor physical function and poor quality of life. Gender, age and cancer diagnosis were significantly associated with most symptoms/problems. The strongest associations between symptoms/problems and gender and age, respectively, were increased risk of nausea in women, as well as increased risk of poor physical function and reduced risk of sleeplessness and pain with increasing age. Patients with brain/central nervous system cancer had the lowest risk of symptoms but the highest risk of poor physical function.

Conclusion At the start of specialised palliative care, patients with cancer experience severe levels of symptoms, poor physical function and poor quality of life. Age, gender and diagnosis were significantly associated with most symptoms/problems, but the strength and direction of the associations differed across symptoms/problems.

  • ‘signs and symptoms’
  • ‘quality of life’
  • ‘palliative care’
  • ‘symptom assessment’
  • ‘needs assessment’ and ‘neoplasms’

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  • Contributors All authors made substantial contributions to the design, analysis of data and critical revision, and approved the publication, participating sufficiently to take responsibility for the content of this article.

  • Funding This work was supported by the Department of Public Health at the University of Copenhagen, the Danish Cancer Society (grant number R94-A5634-14-S9), and the Clinical Quality Programme of the Regions of Denmark (grant number: RKKP-0031/q/01).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was based only on registers from the Danish Palliative Care Database; therefore, it had no impact on any individual care and did not require ethics committee approval according to Danish law. The study was conducted following approval from the Danish Data Protection Agency ( 2007-58-0015/local BFH-2014-033 I-Suite no. 02953).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The data used in this study are available through the Danish Palliative Care Database. Restrictions apply to the availability of these data.