• Tania Pastrana, Katja Seitz, Luc Deliens, and Joachim Cohen.
• RWTH Aachen University Medical Faculty, Aachen, Germany. Electronic address: tpastrana@ukaachen.de.
• Lancet Oncol. 2022 Jul 1; 23 Suppl 1: S36.

BackgroundCancer is the second leading cause of death in almost all Latin American countries. Knowing where people with cancer die and understanding the factors that affect where they die are public health issues, relevant for the development of policies that ensure the provision of adequate end-of-life care in alignment with patients' needs and preferences. The objective of this study was to describe and compare the place of death of people with cancer in 12 Latin American countries, and explore associated factors.MethodsWe conducted a total population observational study using death certificate data from 12 countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Mexico, Paraguay, Peru, and Uruguay). Data from individuals deceased during the most recent full year (Jan 1 to Dec 31) with available data (2016, 2017, or 2018) were included. Place of death was categorised as home, hospital, or other places. The sociodemographic factors, cause of death (10th revision of the International Statistical Classification of Diseases and Related Health Problem cancer codes C00-C97 vs others), and ecological factors were estimated, and a multivariable binary logistic regression analysis with the dependent variable home death versus hospital death was done.Findings3 001 640 deaths were included, of which 491 929 (16·4%) were caused by cancer, ranging from 3161 (8·7%) of 36 441 deaths in El Salvador to 26 027 (33·4%%) of 77 999 deaths in Chile. 1808 (57·2%) of 3161 cancer deaths in El Salvador were in women, a rate that decreased to 3591 (45·5%) of 7884 deaths in Uruguay, but that remained above 50% in half of the included countries (Colombia, Ecuador, El Salvador, Guatemala, Mexico, and Peru). In all countries, 199 900 (40·7%) of 491 574 patients with cancer died before the age of 64 years. Between 32 513 (14·9%) of 217 697 (in Brazil) and 6216 (80·3%) of 7738 (in Guatemala) cancer deaths occurred at home; whereas 175 464 (80·6%) of 217 697 (in Brazil) and 1033 (13·3%) of 7738 (in Guatemala) cancer deaths occurred in hospital. The odds ratios for death at home for people with cancer aged 50-79 years was 1·6 (95% CI 1·6-1·7; p<0·001) and 3·0 (2·9-3·0; p<0·001) for people aged 80 years and older, comparing with those younger than 50 years.InterpretationFactors affecting place of death patterns in Latin America are country-specific. A high percentage of people dying at home does not necessarily suggest a good palliative care provision, especially in countries with poor palliative care programmes. The health facilities available in each country might explain the variations in the number of places where people die. These findings show current needs and can help to guide different policies to improve end-of-life care for patients with cancer.FundingNone.Copyright © 2022 Elsevier Ltd. All rights reserved.

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