High-intensity treatment is common at the end of life among children and young people who died of cancer: a retrospective cohort study

Background Annually, approximately 500 children and young people (aged Aim The primary aim of this study was to establish the prevalence of high-intensity treatment at the end of life in England and assess the relationship between high-intensity treatment and palliative care integration in main cancer treatment centres. The secondary aim was to assess the relationship between palliative care integration and place of death. Design Retrospective, national full-population cohort study. Setting/participants English Cancer Registry data with linked hospitalisation, treatment and intensive care data were used to define a cohort aged Results 2208 (52%) of the cohort (n=4247) had high-intensity treatments at the end of life and 1911 (45%) died in hospital. High-intensity treatment prevalence varied by age at death and cancer type. There was no evidence of health inequalities in treatments, but minority ethnic groups and those living in more deprived areas had greater odds of dying in hospital. Conclusions High-intensity treatment is common at the end of life among children and young people with cancer; however, its appropriateness is difficult to evaluate. Nevertheless, no evidence of health inequalities was noted, and hospital deaths remain most common.