Incidence and relative survival of myeloma by ethnic group was estimated using data from cancer registries in England (2002-2008). Multiple imputation was used to address missing ethnicity data. In total 24 361 cases of myeloma were identified. Age-standardized incidence rate (ASIR) (per 100 000) was higher in the Black ethnic category at 15.00 (95% confidence interval [CI] 13.50-16.40), than amongst South Asians (ASIR = 5.45, 95% CI 4.76-6.14) or the White group (ASIR = 6.11, 95% CI 6.00-6.22). There was a lower risk of death in the Black group for both 1- and 3-year survival (hazard ratio [HR]1 year = 0.66, 95% CI 0.55-0.79; HR3 year = 0.69, 95% CI 0.58-0.83) and South Asians at 1, 3 and 5 years (HR1 year = 0.65, 95% CI 0.51-0.82; HR3 year = 0.72, 95% CI I 0.57-0.90; HR5 year = 0.68, 95% CI 0.50-0.92) when compared to the White population. Further study of differences in myeloma and precursor biology between population groups is important.
Introduction
People dying from haematological cancer are more likely to do so in hospital than is the case for other cancers. We are assessing the utility of data linkage to provide insights into this and other patterns in end of life care, contrasting these malignancies with colorectal cancer.
Aims and Methods
To explore secondary care patterns in the last year of life, we assessed linkage between mortality data and Hospital Episode Statistics (HES) inpatient records. Deaths from haematological and colorectal cancers in England in 2008 were identified from national death registrations and linked to cancer registration and HES inpatient data. Sex, age and place of death distributions were compared.
Results
Ninety percent of 9952 persons who died from haematological cancer and 85% of 13 040 persons who died from colorectal cancer were linked to hospital admissions in the last year of life. More men (55%) than women died from both these cancers and over 80% of deaths occurred in those aged over 65yrs. More haematological than colorectal cancer deaths occurred in hospital (64% vs 38%), and fewer at home (17% vs 28%) or in a hospice (10% vs 19%). Similar distributions by sex, age and place of death were found among persons with a hospital admission in the last year of life.
Conclusions
Linkage of national mortality data to HES records was largely comprehensive and representative of all deaths from these cancers. This national linked dataset will support further exploration of differences in healthcare activity between these cancers at the end of life.
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