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Br J Cancer. 2011 Jan 4;104(1):60-7. doi: 10.1038/sj.bjc.6606036.
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.
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.
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.
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.
最近的研究表明，与挪威和瑞典相比，英格兰乳腺癌和结直肠癌患者的死亡风险在随访的第一年，尤其是在第一个月，会在老年人群中显著增加。本研究旨在探索 2003 年至 2007 年期间苏格兰诊断出此类癌症后 30 天内死亡的患者的特征。
提取匿名癌症登记处记录，并与医院出院和死亡记录相关联。研究人群分为在诊断后 30 天内死亡的患者（病例）和超过该时间阈值存活的患者（对照组）。使用 χ(2)-检验和逻辑回归评估患者、肿瘤和卫生服务相关特征的差异。
在 30 天内死亡的患者更可能是老年人，并且更有可能经历非外科专业的紧急入院。他们的肿瘤更不可能经过显微镜验证，但似乎更有可能是高级别和晚期的。相当数量的患者死于癌症以外的其他原因。
这些结果表明，乳腺癌或结直肠癌诊断后的早期死亡率可能部分归因于合并症和生活方式因素，以及更晚期的疾病。需要进一步研究以确定这些发现的确切解释，特别是是否存在任何潜在可避免的因素，如就诊、转诊或诊断延迟。
