Factors related with mortality due to progression of disease in patients with colon cancer in the presence of competing risks: a retrospective cohort study in the west of Iran
Gastroenterology and Hepatology from Bed to Bench,
26 April 2021
Aim: This study aims to identify the risk factors of death disease-related in patients with colon cancer in the presence of competing risks.
Background: The competing risk analysis is the effective method for identifying risk factors of death for diseases and the evidence related to death prognosis in patients with colon cancer in the country is rare.
Methods: In this historical cohort study, the information of 196 patients with colon cancer who were referred to Imam Khomeini clinic in Hamadan during the years of 2003 to 2017 were examined. In this study, death due to the progression of cancer was considered an interested cause and death related to other causes were considered as competing event. Predictors of death due to the progression of cancer were determined in the presence of competing risks. The cause-specific hazard regression model was used to determine the effect of covariates. Data were analyzed using R software vol 3.4.3 and survival packages.
Results: The mean (SD) age of patients was 57.1 (12.9) years and 52.6% were male. The results of the multivariate cause-specific hazard regression model showed that the patient's age at the time of cancer diagnosis, T stage, stage of the disease and the N stage had a significant effect on the hazard of death due to cancer progression (P <0.05).
Conclusion: In the presence of various causes of death, in order to identify the risk factors of each cause separately, using the cause-specific hazard model can have better support for clinical decisions compared to other models.
Keywords: Competing risk, Colon cancer, cause-specific risk, Death due to cancer progression