Johnston G M, Urquhart R, Lethbridge L, MacIntyre M
School of Health Administration, Dalhousie University, Halifax, Canada; Surveillance and Epidemiology Unit, Cancer Care Nova Scotia, Halifax, Canada.
Department of Surgery, Dalhousie University, Halifax, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada.
Prog Palliat Care. 2016 May 3;24(3):147-152. doi: 10.1080/09699260.2015.1108638. Epub 2015 Dec 26.
: Screening and treatment for breast cancer have improved. However, attention to palliative support and non-cancer co-morbidities has been limited. This study identified types of care for and co-morbidities of persons dying of breast cancer compared to persons dying from all cancers and from non-cancer causes. : Linked administrative data from population-based registries were used to examine 121,458 deaths in Nova Scotia from 1995 to 2009. : Breast cancer decedents' mean age was similar to that of all cancer decedents (72.0 versus 72.1 years), but their age spread was greater (20-59 years: 23.1% versus 16.7%; 90+ years: 11.2% versus 6.5%). Among women dying of breast cancer, 15.6% were enrolled in the diabetes registry and 15.1% in the cardiovascular registry, indicating that they had these non-cancer conditions prior to their death. Compared to all cancer decedents, breast cancer decedents were twice as likely to have dementia as a cause of death, and were less likely to die in hospital but more likely to die in a nursing home. Breast cancer decedents had place of death rates more similar to non-cancer than cancer decedents. : Rates of dementia and diabetes among the breast cancer decedents were particularly note-worthy in this novel study given that these comorbidities have not received much attention in the breast cancer research literature. Further collaboration with non-cancer disease programs is advised. The extent of adequate comprehensive palliative support for the 20% of the breast cancer decedents who are nursing home residents requires investigation.
乳腺癌的筛查和治疗已有改善。然而，对姑息支持和非癌症合并症的关注一直有限。本研究确定了死于乳腺癌的患者与死于所有癌症及非癌症病因的患者相比，其护理类型和合并症情况。：利用基于人群登记处的关联行政数据，对1995年至2009年新斯科舍省的121,458例死亡病例进行了研究。：乳腺癌死者的平均年龄与所有癌症死者相似（分别为72.0岁和72.1岁），但其年龄跨度更大（20 - 59岁：23.1%对16.7%；90岁及以上：11.2%对6.5%）。在死于乳腺癌的女性中，15.6%登记患有糖尿病，15.1%登记患有心血管疾病，这表明她们在死亡前就患有这些非癌症疾病。与所有癌症死者相比，乳腺癌死者因痴呆症死亡的可能性是前者的两倍，在医院死亡的可能性较小，但在养老院死亡的可能性较大。乳腺癌死者的死亡地点比例与非癌症死者而非癌症死者更为相似。：鉴于这些合并症在乳腺癌研究文献中未得到太多关注，在这项新研究中，乳腺癌死者中的痴呆症和糖尿病发病率尤其值得注意。建议与非癌症疾病项目进一步合作。对于20%居住在养老院的乳腺癌死者，需要调查其获得充分全面姑息支持的程度。
