Mortality of patients examined at a diagnostic centre: A matched cohort study

BACKGROUND: 'Diagnostic Centres' has been established to provide a diagnostic pathway for patients with non-specific, serious symptoms that could be cancer. As little is known about the prognosis, we aimed to 1) analyse mortality of patients examined at the diagnostic centre, stratified on diagnostic outcome (cancer, serious-non-malignant disease, or other/no diagnosis), and 2) compare mortality for cancer patients examined at the diagnostic centre with cancer patients diagnosed through other routes.

METHOD: Retrospective cohort study including 938 patients examined at the Diagnostic Centre, Silkeborg Regional Hospital, Denmark, during 2012-2014. Cancer patients examined at the diagnostic centre were matched (1:10) to a reference group of cancer patients diagnosed through other routes. Information on diagnosis, death, comorbidity and socioeconomic factors was obtained by linkage to national Danish registers. Mortality was assessed by Kaplan Meier mortality survival analysis and hazard ratios of death were estimated using Cox proportional regression analysis while adjusting for confounders.

RESULTS: The 1-year cumulative mortality was 28% in cancer patients examined at the diagnostic centre. The hazard ratio of death was seven times increased in cancer patients compared to patients with other/no diagnosis. The hazard ratio of death was 0.91 (95% CI: 0.68; 1.22) in cancer patients examined at the diagnostic centre compared to cancer patients diagnosed through other routes.

DISCUSSION: The mortality among cancer patients examined at the diagnostic centre was comparable to cancer patients diagnosed through other routes. The results indicate that cancer patients with non-specific serious symptoms do not have a worse prognosis than other cancer patients.