Bubis LD, Davis LE, Canaj H, et al. - Researchers investigated cancer outpatients for the prevalence of severe patient-reported symptoms during the 6 months before death. Further, they sought to recognize patient groups at a higher risk for reporting severe symptoms. At regional cancer centers, they identified 39,084 cancer decedents from 2010 to 2016; of these, 22,650 had one or more symptom assessments recorded in the last 6 months of life, resulting in 92,757 ESAS assessments. Observations revealed high rates of severe patient-reported symptom scores before death for outpatients with cancer despite an integrated symptom screening program. The highest severe scores were reported for tiredness (56%), lack of appetite (46%), and impaired well-being (45%). The risk of reporting severe scores was higher for the elderly, women, patients with high comorbidity, immigrants, and living in urban areas or with high material deprivation. Targeted interventions may benefit patient subgroups at increased risk of severe symptom burden.