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For many people, a diagnosis of cancer provokes fear and anxiety. In fact, in a recently released study of women diagnosed with early breast cancer, 50% had clinically important signs of depression, anxiety or both in the year after diagnosis (Burgess et al. 2005). Statistics Canada data shows that five-year relative survival rates are over 80% for this and other types of cancer (Canadian Institute for Health Information 2002). A cancer diagnosis often triggers people to plan next steps. For some people, this involves planning for recovery; for others, it means making decisions about their end-of-life care. Despite good evidence to suggest that the majority of people diagnosed with cancer would rather have end-of-life care in the home (Flory et al. 2004), most Canadians diagnosed with cancer die in acute care facilities. According to a recent report, despite declining in-hospital death rates for cancer, approximately three out of four people in Canada diagnosed with cancer die in hospital (Health Canada 2004). Here we highlight how trends in in-hospital deaths differ for breast, prostate, colorectal and lung cancer. Deaths related to these four cancers account for approximately 50% of all cancer deaths in Canada. Knowing where people die matters because it helps to inform decisions about how healthcare should be organized to support those in need of end-of-life care (Flory et al. 2004).

CIHI Survey: Dying of Cancer in Canada's Acute Care Facilities