Preferences for place of death if faced with advanced cancer: a population survey in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain

B. Gomes*, I. J. Higginson, N. Calanzani, J. Cohen, L. Deliens, B. A. Daveson, D. Bechinger-English, C. Bausewein, P. L. Ferreira, F. Toscani, A. Menaca, Marjolein Gysels, L. Ceulemans, S. T. Simon, H. R. W. Pasman, G. Albers, S. Hall, Fliss Murtagh, D. F. Haugen, J. DowningJ. Koffman, F. Pettenati, S. Finetti, B. Antunes, Richard Harding-Swale, PRISMA

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

394 Citations (Scopus)


Background Cancer end-of-life care (EoLC) policies assume people want to die at home. We aimed to examine variations in preferences for place of death cross-nationally.

Methods A telephone survey of a random sample of individuals aged ≥16 in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain. We determined where people would prefer to die if they had a serious illness such as advanced cancer, facilitating circumstances, personal values and experiences of illness, death and dying.

Results Of 9344 participants, between 51% (95% CI: 48% to 54%) in Portugal and 84% (95% CI: 82% to 86%) in the Netherlands would prefer to die at home. Cross-national analysis found there to be an influence of circumstances and values but not of experiences of illness, death and dying. Four factors were associated with a preference for home death in more than one country: younger age up to 70+ (Germany, the Netherlands, Portugal, Spain), increased importance of dying in the preferred place (England, Germany, Portugal, Spain), prioritizing keeping a positive attitude (Germany, Spain) and wanting to involve family in decisions if incapable (Flanders, Portugal).

Conclusions At least two-thirds of people prefer a home death in all but one country studied. The strong association with personal values suggests keeping home care at the heart of cancer EoLC.
Original languageEnglish
Article numbermdr602
Pages (from-to)2006-2015
Number of pages10
JournalAnnals of Oncology
Issue number8
Early online date16 Feb 2012
Publication statusPublished - Aug 2012


  • TIME
  • LIFE
  • HOME
  • neoplasms
  • health care surveys
  • Europe
  • CARE
  • palliative care
  • public health

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