Early mortality from colorectal cancer in England: a retrospective observational study of the factors associated with death in the first year after diagnosis
Early mortality from colorectal cancer in England: a retrospective observational study of the factors associated with death in the first year after diagnosis
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DOI：
10.1038/bjc.2012.585
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发表时间：
2013-02-19
影响因子：
8.8
通讯作者：
Morris, E. J. A.
中科院分区：
文献类型：
--
作者：
Downing, A.;Aravani, A.;Morris, E. J. A.
背景：英国在结直肠癌生存率的国际比较中表现不佳，大部分是由于接近诊断时死亡人数较多。这项回顾性队列研究调查了疾病诊断后第一年死亡患者的患者、肿瘤和治疗特征。方法：在国家癌症数据库中确定了 2006 年至 2008 年期间英格兰诊断患有结肠癌 (n=65733) 或直肠癌 (n=26123) 的患者。采用多变量逻辑回归分析诊断后1个月、1-3个月和3-12个月内的死亡几率。结果：总共有11.5%的结肠癌和5.4%的直肠癌患者在诊断后一个月内死亡：这一比例在研究期间显着下降。对于这两个癌症部位，年龄较大、诊断阶段、剥夺和紧急就诊均与早期死亡相关。诊断后不久死亡的个体也更有可能缺失有关重要预后因素（例如疾病分期和治疗）的数据。 结论：在不给患者带来不便的情况下，利用常规收集的数据，我们已经确定了与结直肠癌早期死亡相关的一些重要领域，值得进一步研究。
Background: The United Kingdom performs poorly in international comparisons of colorectal cancer survival with much of the deficit owing to high numbers of deaths close to the time of diagnosis. This retrospective cohort study investigates the patient, tumour and treatment characteristics of those who die in the first year after diagnosis of their disease.Methods: Patients diagnosed with colon (n=65733) or rectal (n=26 123) cancer in England between 2006 and 2008 were identified in the National Cancer Data Repository. Multivariable logistic regression was used to investigate the odds of death within 1 month, 1-3 months and 3-12 months after diagnosis.Results: In all, 11.5% of colon and 5.4% of rectal cancer patients died within a month of diagnosis: this proportion decreased significantly over the study period. For both cancer sites, older age, stage at diagnosis, deprivation and emergency presentation were associated with early death. Individuals who died shortly after diagnosis were also more likely to have missing data about important prognostic factors such as disease stage and treatment.Conclusion: Using routinely collected data, at no inconvenience to patients, we have identified some important areas relating to early deaths from colorectal cancer, which merit further research.