Cuidados paliativos y desigualdades sociales en cáncer. Una revisión narrativa de la literatura

Objectives: To conduct a broad literature review in order to: a) propose a grouping and a classification of the different approaches described in the literature to analyse the access and use of palliative care in advanced cancer patients, and b) review the social inequalities examined in the literature in relation to the access and the use of palliative care in advanced cancer patients. Methods: Narrative review using the Embase, CINAHL, and PubMed databases until November 2022. Results: 2,666 articles were retrieved and screened by title and abstract with included studies read in full for data extraction. Five main themes of the different approaches were identified in relation to access and use of palliative care: a) symptom management, b) adequacy and quality of care, c) appropriate palliative care, d) advance care planning and e) place of death. Older people, men, from a minority ethnic group, of low socioeconomic status and residing in rural areas are less likely to access to palliative care to relieve pain and suffering produced from cancer disease and at end of life. Conclusions: Palliative care is considered an essential component to provide comprehensive care throughout the cancer disease continuum. However, despite the existence of scientific evidence that recommends the integration of palliative care from the diagnosis of the disease, age, sex, ethnicity, socioeconomic level and residence create inequity in access and use of palliative care in patients with advanced cancer, producing groups of greater structural vulnerability.