January 2, 2009

CONTACT: Kim Guenther
(215) 662-6183

Requirement to Forgo Cancer Treatment Causes Racial Disparities in Hospice Use, Penn Researchers Find

Despite Greater Perceived Need for Hospice Services, Aggressive Treatment Preferences Block Many African-Americans from Hospice Medicare Eligibility

PHILADELPHIA – Racial disparities in end of life cancer care may be caused by a preference for continuing aggressive treatment – a decision that blocks enrollment in hospice care – according to a study by Jessica Fishman, PhD and David J. Casarett, MD, MA, of the University of Pennsylvania School of Medicine and Veterans Affairs Center for Health Equity Research and Promotion, and colleagues. In this study, African-Americans patients with cancer were less willing to give up treatment, compared with white patients. In addition, African-American patients reported greater needs for hospice services (i.e. counselor, respite care, chaplain, nurse), despite the fact that their cancer treatment preferences would exclude them from most hospice programs. The study, published early online last week by CANCER, a peer-reviewed journal of the American Cancer Society, indicates that the eligibility criteria for hospice services should be reconsidered.

“Hospice should not require patients to give up cancer treatment in order to enroll, because this prevents those patients with the greatest need from receiving hospice care,” said Dr. Casarett. “We should determine eligibility for hospice in the same way that we determine eligibility for other medical treatments and services: based on the patient’s need.”

Please read the CANCER press release or the full study for more information.


PENN Medicine is a $3.6 billion enterprise dedicated to the related missions of medical education, biomedical research, and excellence in patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System.

Penn's School of Medicine is currently ranked #4 in the nation in U.S.News & World Report's survey of top research-oriented medical schools; and, according to most recent data from the National Institutes of Health, received over $379 million in NIH research funds in the 2006 fiscal year. Supporting 1,700 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

The University of Pennsylvania Health System (UPHS) includes its flagship hospital, the Hospital of the University of Pennsylvania, rated one of the nation’s top ten “Honor Roll” hospitals by U.S.News & World Report; Pennsylvania Hospital, the nation's first hospital; and Penn Presbyterian Medical Center. In addition UPHS includes a primary-care provider network; a faculty practice plan; home care, hospice, and nursing home; three multispecialty satellite facilities; as well as the Penn Medicine Rittenhouse campus, which offers comprehensive inpatient rehabilitation facilities and outpatient services in multiple specialties.

This release is available online at