Characteristics of patients dying within 30 days of diagnosis of breast or colorectal cancer in Scotland, 2003-2007

• Published in: British journal of cancer Vol. 104; no. 1; pp. 60 - 67
• Main Authors: Brewster, D H, Clark, D I, Stockton, D L, Munro, A J, Steele, R J C
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 04.01.2011; Nature Publishing Group
• Subjects: 692/699/67/1347; 692/699/67/1504/1885; 692/699/67/2324; 692/700/139; Aged; Aged, 80 and over; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Breast Neoplasms - diagnosis; Breast Neoplasms - mortality; Cancer Research; Case-Control Studies; Clinical Study; Cohort Studies; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - mortality; Comorbidity; Drug Resistance; Epidemiology; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Life Style; Male; Mammary gland diseases; Medical sciences; Molecular Medicine; Neoplasm Staging; Oncology; Prognosis; Registries; Risk Factors; Scotland; Socioeconomic Factors; Survival Rate; Time Factors; Tumors; United Kingdom; Scotland; Great Britain; Europe; Sweden; British Isles, Scotland; British Isles, England; Norway; mortality; Scotland; co-morbidity; breast neoplasms; colorectal neoplasms; survival; Human; Rectal disease; Breast disease; Mortality; Breast tumor; Colorectal cancer; Breast cancer; Malignant tumor; Survival; Morbidity; Colonic disease; Mammary gland diseases; Cancerology; Digestive diseases; Intestinal disease; Diagnosis; Cancer
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6606036

Background: Recent research has shown that most of the excess risk of death following breast and colorectal cancer in England compared with Norway and Sweden occurs in older age groups during the first year, and especially in the first month of follow-up. The aim of this study was to explore the characteristics of patients dying within 30 days of being diagnosed with one of these cancers in Scotland during 2003–2007. Methods: Anonymised cancer registry records linked to hospital discharge and death records were extracted. The study population was divided into patients who died within 30 days of diagnosis (cases) and those who survived beyond this threshold (controls). Differences in patient-, tumour-, and health service-related characteristics were assessed using the χ 2 -test and logistic regression. Results: Patients dying within 30 days were more likely to be elderly and to have experienced emergency admission to non-surgical specialities. Their tumours were less likely to have been verified microscopically, but they appeared more likely to be of high grade and advanced in stage. A substantial number of patients died from causes other than their cancer. Conclusion: These results suggest that early mortality after a diagnosis of breast or colorectal cancer may be partly due to comorbidity and lifestyle factors, as well as due to more advanced disease. Further research is required to determine the precise explanation for these findings and, in particular, if any potentially avoidable factors such as delays in presentation, referral, or diagnosis exist.