Predictors of an early death in patients diagnosed with colon cancer: A retrospective case-control study in the UK

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dc.contributor.author Donnelly, Conan
dc.contributor.author Hart, Nigel
dc.contributor.author McCrorie, Alan David
dc.contributor.author Donnelly, Michael
dc.contributor.author Anderson, Lesley
dc.contributor.author Ranaghan, Lisa
dc.contributor.author Gavin, Anna
dc.date.accessioned 2019-09-11T09:20:57Z
dc.date.available 2019-09-11T09:20:57Z
dc.date.issued 2019-06-19
dc.identifier.citation Donnelly, C., Hart, N., McCrorie, A. D., Donnelly, M., Anderson, L., Ranaghan, L. and Gavin, A. (2019) 'Predictors of an early death in patients diagnosed with colon cancer: a retrospective case–control study in the UK', BMJ Open, 9(6), e026057. DOI: 10.1136/bmjopen-2018-026057 en
dc.identifier.volume 9 en
dc.identifier.issued 6 en
dc.identifier.startpage 1 en
dc.identifier.endpage 12 en
dc.identifier.uri http://hdl.handle.net/10468/8513
dc.identifier.doi 10.1136/bmjopen-2018-026057 en
dc.description.abstract Objective: Despite considerable improvements, 5-year survival rates for colon cancer in the UK remain poor when compared with other socioeconomically similar countries. Variation in 5-year survival can be partly explained by higher rates of death within 3 months of diagnosis in the UK. This study investigated the characteristics of patients who died within 3 months of a diagnosis of colon cancer with the aim of identifying specific patient factors that can be addressed or accounted for to improve survival outcomes.Design: A retrospective case–control study design was applied with matching on age, sex and year diagnosed. Patient, disease, clinical and service characteristics of patients diagnosed with colon cancer in a UK region (2005–2010) who survived less than 3 months from diagnosis (cases) were compared with patients who survived between 6 and 36 months (controls). Patient and clinical data were sourced from general practice notes and hospital databases 1–3 years prediagnosis.Results: Being older (aged ≥78 years) and living in deprivation quintile 5 (OR=2.64, 95% CI 1.15 to 6.06), being unmarried and living alone (OR=1.64, 95% CI 1.07 to 2.50), being underweight compared with normal weight or obese (OR=3.99, 95% CI 1.14 to 14.0), and being older and living in a rural as opposed to urban area (OR=1.96, 95% CI 1.21 to 3.17) were all independent predictors of early death from colon cancer. Missing information was also associated with early death, including unknown stage, histological type and marital/accommodation status after accounting for other factors.Conclusion: Several factors typically associated with social isolation were a recurring theme in patients who died early from colon cancer. This association is unexplained by clinical or diagnostic pathway characteristics. Socially isolated patients are a key target group to improve outcomes of the worst surviving patients, but further investigation is required to determine if being isolated itself is actually a cause of early death from colon cancer. en
dc.description.sponsorship Cancer Research UK (National Awareness & Early Diagnosis Initiative (Principal Investigator: AG, Co-Investigators:CD, NH, ADM, MD, LR LA); Public Health Agency (Northern Ireland Cancer Registry) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BMJ Publishing Group en
dc.relation.uri https://bmjopen.bmj.com/content/9/6/e026057
dc.rights ©Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Predictors en
dc.subject Early death en
dc.subject Colon cancer en
dc.title Predictors of an early death in patients diagnosed with colon cancer: A retrospective case-control study in the UK en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Conan Donnelly, School of Epidemiology and Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: c.donnelly@nicr.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Cancer Research UK en
dc.contributor.funder Public Health Agency en
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMJ Open en
dc.internal.IRISemailaddress c.donnelly@nicr.ie en
dc.identifier.articleid e026057 en
dc.identifier.eissn 2044-6055


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©Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. Except where otherwise noted, this item's license is described as ©Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
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