BMJ  2006;332:668 (18 March), doi:10.1136/bmj.332.7542.668

Letter

Where patients with cancer die in Cuba

The first 150 words of the full text of this article appear below.

EDITOR—Gomes and Higginson show that identifying the factors influencing where terminally ill patients with cancer die is complicated.¹

In 1981-2 we studied 13 105 deaths in adults (>15) in three different Cuban provinces. Only 27.0% of adult deaths due to malignant tumours occurred outside hospitals in Ciudad de La Habana, a western province that includes the capital of Cuba, compared with 60.2% in Cienfuegos, in the centre and southern part of the island, and 58.2% in Las Tunas, in the eastern side. The people who died at home were older than those in hospital, were found less in urban areas, and showed no variation by sex.²

We then studied adult mortality in the same three Cuban provinces over 10 years from 1990 to 1999. There were 36 999 deaths due to malignant tumours in Ciudad de La Habana (19.3% of all deaths), 5269 in Cienfuegos (19.9%), and 5820 . . . [Full text of this article]

Municipal Health Division of Cienfuegos, Ave 56 No 2917 altos, Cienfuegos 55100, Cuba espinosa@perla.inf.cu

Teaching Hospital "Dr Gustavo Aldereguia Lima," Cienfuegos, Ave 5 de Septiembre and Calle 51A, Cienfuegos 55100

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