Chemotherapy use and associated factors among cancer patients near the end of life.

Objectives: We investigated the frequency of chemotherapy use and its associated factors in patients in all age groups in the last year of life.

Methods: We identified cancer patients who died in 2004 in any of 17 hospitals. We used demographic and treatment characteristics by computerized hospital information systems and by linking the identification numbers to the 2004 death registry.

Results: 48.7% of patients in the last 6 months of life, 43.9% in the last 3 months, and 30.9% in the last month of life received chemotherapy. The frequency of chemotherapy use was lower for older patients. In those > or =65 years old, there was no difference between women and men in the proportion that received chemotherapy. For patients <65 years of age, a larger proportion of women than men received chemotherapy, and chemotherapy use was significantly less frequent for patients with refractory disease than for those with responsive disease. Patients dying at a relatively small hospital without a hospice inpatient unit were significantly more likely to receive chemotherapy.

Conclusions: Despite the fact that most cancer patients are resistant to chemotherapy at the end of life, it was administered often to all age groups.