Nearly all patients with metastatic cancer treated in oncology departments meet at least one internationally agreed criterion for palliative care referral, yet only a minority had actually seen a palliative care team in the preceding three months. That is the central finding of a prospective multicenter cross-sectional study published in BMC Palliative Care, which examined how often consensus-based referral criteria are met in routine practice and how often they translate into timely consultations.
Consensual criteria for timely palliative care referral in advanced cancer were previously defined through an international Delphi process, but it remained unclear how frequently patients meet these criteria and how often meeting them leads to contact with a palliative care team. To address this gap, researchers enrolled outpatients and inpatients with metastatic cancer from oncology departments in eight hospitals, assessing the prevalence of referral criteria and of palliative care consultations occurring within the past three months. The trial was registered with ClinicalTrials.gov under identifier NCT05339945 on April 21, 2022.
The study included 355 patients with metastatic cancer, with an average age of 65.7 years and 52.4% female. Of these, 265 patients (74.6%) were outpatients and 90 (25.4%) were inpatients. The most commonly met criteria were an estimated prognosis of less than one year, met by 235 patients (66.2%); a need for assistance with decision-making or care planning, met by 214 patients (60.3%); and severe physical symptoms, met by 148 patients (41.7%). Overall, 334 patients (94.1%) met at least one criterion, 71% met at least two, and 47% met at least three.
Despite this high burden of supportive care needs, only 133 patients (37.5%) had a palliative care consultation in the past three months. The researchers also observed significant differences between care settings. Inpatients met referral criteria more frequently than outpatients, at 98.9% versus 92.5% (p = 0.048), and had a substantially higher rate of recent palliative care consultation, at 52.2% versus 32.5% (p = 0.001).
A striking result emerged from the multivariable analysis: inpatient care setting and a performance status of 2 were independently associated with having had a recent palliative care consultation, whereas none of the 11 consensus criteria was. In other words, the formal screening criteria themselves did not predict which patients had recently been seen by palliative care; where patients were being treated and their functional status did.
The authors conclude that screening for referral criteria revealed that a substantial majority of patients had supportive care needs warranting palliative care referral, particularly in the inpatient setting. Only a minority of these patients had a recent palliative care consultation, a discrepancy the researchers interpret as suggesting opportunities to streamline the referral process. Because the study is cross-sectional, it captures a single point in time and shows associations rather than causal effects; the reported consultation rates reflect a three-month look-back window among hospitalized and ambulatory oncology patients, and the findings describe this cohort rather than establishing that criteria-based screening alone improves referral timeliness.
Subject of Research: Prevalence of palliative care referral criteria and recent consultations among patients with metastatic cancer
Article Title: Referral criteria for timely palliative care in metastatic cancer: a real-life cross-sectional study
Article References: Sahut d’Izarn, M., Bouleuc, C., Hui, D., Vinant, P., Joffin, I., Vincent, B., Barth, C., Serresse, L., Ya-de-Rauglaudre, L., Jacota, M., Gassama, M., & de Stampa, M. (2026). Referral criteria for timely palliative care in metastatic cancer: a real-life cross-sectional study. BMC Palliative Care. https://doi.org/10.1186/s12904-026-02382-9
Image Credits: AI Generated
DOI: 10.1186/s12904-026-02382-9
Keywords: palliative care, metastatic cancer, referral criteria, cross-sectional study, oncology, supportive care, inpatients, outpatients, Delphi consensus, performance status, Referral, criteria
News Source: Nathaniel Bowman. (October 29, 2026). Most Metastatic Cancer Patients Meet Palliative Care Referral Criteria, Yet Few Receive It. Scienmag.
