Risk factors for early death among ovarian cancer patients: A nationwide cohort study
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Risk factors for early death among ovarian cancer patients : A nationwide cohort study. / Mosgaard, Berit Jul; Meaidi, Amani; Høgdall, Claus; Noer, Mette Calundann.
I: Journal of Gynecologic Oncology, Bind 31, Nr. 3, e30, 2020.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Risk factors for early death among ovarian cancer patients
T2 - A nationwide cohort study
AU - Mosgaard, Berit Jul
AU - Meaidi, Amani
AU - Høgdall, Claus
AU - Noer, Mette Calundann
PY - 2020
Y1 - 2020
N2 - Objective: To characterize ovarian cancer patients who die within 6 months of diagnosis and to identify prognostic factors for these early deaths. Methods: A nationwide cohort study covering ovarian cancer in Denmark in 2005–2016. Tumor and patient characteristics including comorbidity and socioeconomic factors were obtained from the comprehensive Danish national registers. Results: A total of 5,570 patients were included in the study. Three months after ovarian cancer diagnosis 456 (8.2%) had died and 664 (11.9%) died within 6 months of diagnosis. Adjusted for age and comorbidity, patients who died early were admitted to hospital significantly more often in a 6-month period before the diagnosis (odds ratio [OR]=1.61 [1.29–2.00], and OR=1.47 [1.21–1.78]), for patients who died within 3 and 6 months respectively). Low educational level (OR=2.11), low income (OR=2.50) and singlehood (OR=1.90) were factors significantly associated with higher risk of early death. The discriminative ability of risk factors in identifying early death was assessed by cross-validated area under the receiver operating characteristic curve (AUC). The AUC was found to be 0.91 (0.88–0.93) and 0.90 (0.87–0.92) for death within 3 and 6 months, respectively. Conclusions: Despite several admissions to hospital, the ovarian cancer diagnosis is delayed for a subgroup of patients, who end up dying early, probably due to physical deterioration in the ineffective waiting time. Up to 90% of high-risk patients might be identified significantly earlier to improve the prognosis. The admittance of the patients having risk symptoms should include fast track investigation for ovarian cancer.
AB - Objective: To characterize ovarian cancer patients who die within 6 months of diagnosis and to identify prognostic factors for these early deaths. Methods: A nationwide cohort study covering ovarian cancer in Denmark in 2005–2016. Tumor and patient characteristics including comorbidity and socioeconomic factors were obtained from the comprehensive Danish national registers. Results: A total of 5,570 patients were included in the study. Three months after ovarian cancer diagnosis 456 (8.2%) had died and 664 (11.9%) died within 6 months of diagnosis. Adjusted for age and comorbidity, patients who died early were admitted to hospital significantly more often in a 6-month period before the diagnosis (odds ratio [OR]=1.61 [1.29–2.00], and OR=1.47 [1.21–1.78]), for patients who died within 3 and 6 months respectively). Low educational level (OR=2.11), low income (OR=2.50) and singlehood (OR=1.90) were factors significantly associated with higher risk of early death. The discriminative ability of risk factors in identifying early death was assessed by cross-validated area under the receiver operating characteristic curve (AUC). The AUC was found to be 0.91 (0.88–0.93) and 0.90 (0.87–0.92) for death within 3 and 6 months, respectively. Conclusions: Despite several admissions to hospital, the ovarian cancer diagnosis is delayed for a subgroup of patients, who end up dying early, probably due to physical deterioration in the ineffective waiting time. Up to 90% of high-risk patients might be identified significantly earlier to improve the prognosis. The admittance of the patients having risk symptoms should include fast track investigation for ovarian cancer.
KW - Comorbidity
KW - Mortality
KW - Ovarian cancer
KW - Prognosis
KW - Socioeconomic factors
KW - Survival
U2 - 10.3802/jgo.2020.31.e30
DO - 10.3802/jgo.2020.31.e30
M3 - Journal article
C2 - 32026656
AN - SCOPUS:85083913234
VL - 31
JO - Journal of Gynecologic Oncology
JF - Journal of Gynecologic Oncology
SN - 2005-0380
IS - 3
M1 - e30
ER -
ID: 256218208