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September 24, 2003

Hospice Use in Medicare Beneficiaries With Cancer—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(12):1578. doi:10.1001/jama.290.12.1578-a

In Reply: We agree with Dr Gagnon that not all patients diagnosed as having cancer should be considered terminally ill from it. Gagnon also notes that hospice use for patients with breast cancer was less than that of patients with lung cancer and suggests that this difference is because of the higher likelihood that patients with breast cancer die from other causes.

We did not suggest that patients dying of breast cancer had less access to hospice than patients with prostate or lung cancer. Indeed, when we restrict our analysis to patients who died from cancer, as ascertained by cause of death, 28.9% of patients with breast cancer, 30.1% of patients with lung cancer, and 31.8% of patients with prostate cancer received hospice care before death.

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