EP187 - Where the Young Go to Die: Contrasting Patterns of Place of Death in Early- vs. Late-Onset Colorectal Cancer

Saturday, May 9, 2026

3:53 PM - 3:58 PM ET

ePoster Presenter(s)

MS

Maryam Sherwani, MBBS

Medical Graduate
Aga Khan University
Karachi, Sindh, Pakistan

Disclosure information not submitted.

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Author(s)

Bradford James, MD

General Surgery Resident
Vanderbilt University Medical Center
Nashville, Tennessee, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

Senior Author(s)

Aimal Khan, MD

Assistant Professor of Surgery
Vanderbilt University Medical Center
Vanderbilt Health
Nashville, TN, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no relevant financial relationships.

Purpose/Background: Place of death is an important indicator of end-of-life care quality. While colorectal cancer (CRC) mortality patterns differ by age, differences in the place of death between early-onset and late-onset CRC remain poorly defined. Examining these patterns may offer insight into variations in healthcare utilization, care intensity, and potential disparities in end-of-life care across age groups. We compared trends and sociodemographic determinants of the place of death in these two groups.

Methods/Interventions: We used the CDC WONDER database to identify deaths from CRC in the United States from 2003-2020 (ICD-10: C18-C20, C78.5). Decedents were categorized as early-onset (18-49 years) or late-onset (≥50 years). Place of death was classified as inpatient hospital, home, hospice facility, nursing home, outpatient/emergency room, or other. Multinomial logistic regression was used to estimate associations between sociodemographic characteristics and location of death.

Results/Outcomes: Among 940,327 CRC deaths, 62,147 (6.6%) were early-onset CRC. Overall distributions of place of death were similar, but late-onset CRC decedents were significantly more likely to die in nursing homes (16.9% vs 5.0%, RRR 4.42, 95% CI 4.24-4.61) (Figure 1). Overall, males were more likely to die in hospitals, while females more often died in nursing homes. Racial disparities were also evident: compared with White patients, Black patients were less likely to die at home (RRR 0.62, 95% CI 0.61-0.63), in hospice facilities (RRR 0.72, 95% CI 0.71-0.74) or in nursing homes (RRR 0.55, 95% CI 0.54-0.56), relative to hospital death.

Conclusion/Discussion: Our study demonstrates important age-related differences in end-of-life care utilization, with late-onset CRC decedents dying more frequently in nursing homes. Beyond age, we also observed sociodemographic disparities: Black patients were less likely to die at home or in hospice facilities and more likely in a hospital setting. Given that patients, families, and healthcare providers generally prefer death at home or in hospice for terminal cancers, these findings point to potential inequities in access to goal-concordant care. They underscore the need for further research and policy interventions to ensure equitable, patient-centered end-of-life care for individuals with CRC.

Figure 1: Distribution of place of death from colorectal cancer between 2003-2020, stratified by age group