title: Early mortality from colorectal cancer in England: a retrospective observational study of the factors associated with death in the first year after diagnosis.
abstract: 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=65,733) 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Cancer Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Level 6, Bexley Wing, St James's Institute of Oncology, St James's University Hospital, Leeds LS9 7TF, UK. a.downing@leeds.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: Downing
authors.forename: A
authors.initials: A
authors.lastname: Aravani
authors.forename: U
authors.initials: U
authors.lastname: Macleod
authors.forename: S
authors.initials: S
authors.lastname: Oliver
authors.forename: P J
authors.initials: PJ
authors.lastname: Finan
authors.forename: J D
authors.initials: JD
authors.lastname: Thomas
authors.forename: P
authors.initials: P
authors.lastname: Quirke
authors.forename: J R
authors.initials: JR
authors.lastname: Wilkinson
authors.forename: E J A
authors.initials: EJ
authors.lastname: Morris
mesh_terms: D000367:Age Factors; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D006113:United Kingdom