title: Characteristics of patients dying within 30 days of diagnosis of breast or colorectal cancer in Scotland, 2003-2007.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, UK. David.Brewster@nhs.net
authors.forename: D H
authors.initials: DH
authors.lastname: Brewster
authors.forename: D I
authors.initials: DI
authors.lastname: Clark
authors.forename: D L
authors.initials: DL
authors.lastname: Stockton
authors.forename: A J
authors.initials: AJ
authors.lastname: Munro
authors.forename: R J C
authors.initials: RJ
authors.lastname: Steele
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D016022:Case-Control Studies; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D012606:Scotland; D012959:Socioeconomic Factors; D015996:Survival Rate; D013997:Time Factors