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Causes of death and metastatic patterns in Swedish cancer patients

Riihimäki, Matias LU (2013) In Lund University Faculty of Medicine Doctoral Dissertation Series 2013:128.
Abstract
This thesis aimed to investigate possibilities to utilize death certificates in cancer epidemiology by analyzing nationwide databases from Sweden. Excessive information is available when investigating causes of death in cancer patients, including comorbidities and metastatic patterns. We used the Swedish Family- Cancer Database, which includes data from e.g. the Cause of Death Register and the Cancer Registry, in our analyses.

Half of prostate and breast cancer patients die from other causes than the respective cancers. Cox regression models were applied, and prostate [paper I] and breast [paper II] cancer patients were found to be at an increased risk of death from various causes, e.g. heart failure, diseases of pulmonary... (More)
This thesis aimed to investigate possibilities to utilize death certificates in cancer epidemiology by analyzing nationwide databases from Sweden. Excessive information is available when investigating causes of death in cancer patients, including comorbidities and metastatic patterns. We used the Swedish Family- Cancer Database, which includes data from e.g. the Cause of Death Register and the Cancer Registry, in our analyses.

Half of prostate and breast cancer patients die from other causes than the respective cancers. Cox regression models were applied, and prostate [paper I] and breast [paper II] cancer patients were found to be at an increased risk of death from various causes, e.g. heart failure, diseases of pulmonary circulation, and external causes, including suicide and falls. Additional information may be found in the multiple causes of death, which reveal that prostate cancer patients are at an increased risk to die from anemia and urinary system diseases. These findings can be explained by both cancer and treatment related mechanisms.

Metastatic patterns in lung cancer were assessed: metastatic sites varied depending on the histological subtype, age, and gender [paper III]. Squamous cell lung cancer was less prone to metastasize than other histological subtypes. Adenocarcinoma tends to metastasize to the bone and within the respiratory system. Small cell lung cancer frequently metastasizes to the liver. Survival in metastatic lung cancer is worst in liver metastases, elderly, and men.

Survival in metastatic cancer is better if the location of the primary tumor is known compared with if the primary location is unknown [paper IV]. There are some exceptions however, cancers of the pancreas, liver, and stomach. Metastases to the liver, irrespective whether the primary tumor is known or unknown are associated with a poor prognosis. (Less)
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author
supervisor
opponent
  • Hakama, Matti, Finnish Cancer Registry
organization
publishing date
type
Thesis
publication status
published
subject
in
Lund University Faculty of Medicine Doctoral Dissertation Series
volume
2013:128
pages
135 pages
publisher
Faculty of Medicine, Lund University
defense location
CRC aula, SUS, Malmö
defense date
2013-12-06 14:00:00
ISSN
1652-8220
ISBN
978-91-87651-03-8
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Psychiatry/Primary Care/Public Health (013240500), Family medicine, psychiatric epidemiology and migration (013240037)
id
bbde4155-d59a-401b-9ffa-f5ad1a345273 (old id 4157219)
date added to LUP
2016-04-01 14:39:15
date last changed
2023-04-18 20:10:03
@phdthesis{bbde4155-d59a-401b-9ffa-f5ad1a345273,
  abstract     = {{This thesis aimed to investigate possibilities to utilize death certificates in cancer epidemiology by analyzing nationwide databases from Sweden. Excessive information is available when investigating causes of death in cancer patients, including comorbidities and metastatic patterns. We used the Swedish Family- Cancer Database, which includes data from e.g. the Cause of Death Register and the Cancer Registry, in our analyses. <br/><br>
Half of prostate and breast cancer patients die from other causes than the respective cancers. Cox regression models were applied, and prostate [paper I] and breast [paper II] cancer patients were found to be at an increased risk of death from various causes, e.g. heart failure, diseases of pulmonary circulation, and external causes, including suicide and falls. Additional information may be found in the multiple causes of death, which reveal that prostate cancer patients are at an increased risk to die from anemia and urinary system diseases. These findings can be explained by both cancer and treatment related mechanisms. <br/><br>
Metastatic patterns in lung cancer were assessed: metastatic sites varied depending on the histological subtype, age, and gender [paper III]. Squamous cell lung cancer was less prone to metastasize than other histological subtypes. Adenocarcinoma tends to metastasize to the bone and within the respiratory system. Small cell lung cancer frequently metastasizes to the liver. Survival in metastatic lung cancer is worst in liver metastases, elderly, and men. <br/><br>
Survival in metastatic cancer is better if the location of the primary tumor is known compared with if the primary location is unknown [paper IV]. There are some exceptions however, cancers of the pancreas, liver, and stomach. Metastases to the liver, irrespective whether the primary tumor is known or unknown are associated with a poor prognosis.}},
  author       = {{Riihimäki, Matias}},
  isbn         = {{978-91-87651-03-8}},
  issn         = {{1652-8220}},
  language     = {{eng}},
  publisher    = {{Faculty of Medicine, Lund University}},
  school       = {{Lund University}},
  series       = {{Lund University Faculty of Medicine Doctoral Dissertation Series}},
  title        = {{Causes of death and metastatic patterns in Swedish cancer patients}},
  volume       = {{2013:128}},
  year         = {{2013}},
}