Injuries Higher During Cancer Diagnosis Process

Preventative strategies necessary to reduce hospital admissions resulting from cancer treatments, medical complications, accidents, and self-harm.

The risk of intentional and unintentional injuries during diagnosis are heightened in cancer patients, according to a recent study.

In an analysis published in The BMJ, authors called for “the prevention of intentional and unintentional injuries during the diagnostic process of cancer,” which includes unintentional injuries derived from medical complications and treatments, other types of injuries such as bruising or fractures from self-harm, and accidents.

For the study, researchers analyzed injury-related hospital admissions in Swedish cancer patients between 1990 and 2010. The diagnostic period was 16 weeks before and after diagnosis, which was compared with a control period the year before diagnosis.

There were a total of 720,901 cancer patients admitted to the hospital during the diagnostic period, with 7306 patients injured from medical complications and drug treatments, and 8331 injuries resulting from accidents and self-harm.

“(The result for the medical related injuries is) not surprising because patients often undergo invasive diagnostic and therapeutic procedures and acquire other comorbidities related to the progressing malignancy and its treatment,” the study authors wrote.

When researchers broke out different patients, they found those with central nervous system and colorectal cancers had a 14.7-fold and 11.5-fold risk increase in these types of injuries. Researchers believe this is most likely due to the higher degree of complication associated with more extensive diagnostic procedures and treatments compared with other types of cancer.

Patients who were younger, cohabiting, of a higher socioeconomic status or education, and no pre-existing psychiatric disorder, had a higher risk of medical complication injuries compared with other patient groups during the diagnostic process.

Another common injury resulted from self-harm and accidents, which had a 5.3-fold risk increase during the 2 weeks before diagnosis. The findings suggest that psychological stress is much higher when patients are expecting a diagnosis.

There was a 2.8-fold increase for patients with central nervous system cancers, 2.8-fold for hematopoietic, and 2.5-fold risk for lung cancers of accidental and self-harm injuries. Those who had a non-melanoma skin cancer diagnosis had the smallest increase relative to other patients, which is most likely due to a relatively benign predicted prognosis.

Compared with other groups, patients who had a lower socioeconomic status or education had a slightly higher increase in risk of unintentional injuries.

“(They may be) more vulnerable because they are facing a stressful life event” study authors said.

A limitation to the study was that the researchers did not account for injuries that did not result in an admission into the hospital, or those that were fatal.

“Some injuries are hard to prevent completely given the intensive diagnostics and treatment during the diagnostic period for cancer,” the authors wrote.

An additional limitation is that the study was observational, so cause and effect cannot be conclusively drawn. Despite this, the findings provide insight into high risk groups.

“Our study sheds light on the high risk types of cancer and groups of patients, providing first hand evidence for clinicians and policy makers to develop targeted prevention strategies,” the authors wrote.