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.authorDonnelly, Conan
dc.contributor.authorHart, Nigel
dc.contributor.authorMcCrorie, Alan David
dc.contributor.authorDonnelly, Michael
dc.contributor.authorAnderson, Lesley
dc.contributor.authorRanaghan, Lisa
dc.contributor.authorGavin, Anna T.
dc.contributor.funderCancer Research UKen
dc.contributor.funderPublic Health Agencyen
dc.date.accessioned2019-09-11T09:20:57Z
dc.date.available2019-09-11T09:20:57Z
dc.date.issued2019-06-19
dc.description.abstractObjective: 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.sponsorshipCancer 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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide026057en
dc.identifier.citationDonnelly, 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. (12pp.) DOI: 10.1136/bmjopen-2018-026057en
dc.identifier.doi10.1136/bmjopen-2018-026057en
dc.identifier.eissn2044-6055
dc.identifier.endpage12en
dc.identifier.issued6en
dc.identifier.journaltitleBMJ Openen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/8513
dc.identifier.volume9en
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.relation.urihttps://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.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectPredictorsen
dc.subjectEarly deathen
dc.subjectColon canceren
dc.titlePredictors of an early death in patients diagnosed with colon cancer: a retrospective case-control study in the UKen
dc.typeArticle (peer-reviewed)en
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