Patients with cancer experience higher risks for injuries — both unintentional and intentional — in the weeks before and after a diagnosis of cancer is made, a study in BMJ has shown.1

Because a cancer diagnosis is a stressful life event and its treatment can be invasive and complex, both unintentional and intentional injuries are increased in these patients after diagnosis. However, little is known about whether these injuries are increased in the immediate time before a diagnosis is made. Therefore, an international team of researchers sought to evaluate whether risks of injuries were increased in the weeks before a diagnosis.

Unintentional injuries include infections, bleeding, or other medical complications associated with diagnostic procedures or treatments. Intentional injuries include bruising or fractures from self harm and accidents.

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For the study, the researchers analyzed all injury-related hospitalizations in 720,901 Swedish patients with cancer between 1990 and 2010, comparing the diagnostic period, defined as 16 weeks before and after diagnosis, with a control period the year before diagnosis.

Their analysis found 7306 injuries resulted from medical complications and drug treatment and 8331 injuries resulted from accidents and self harm among the total study population.

The study findings were not surprising to the researchers. Diagnostic and therapeutic procedures can be invasive, in addition to acquiring comorbidities related to progressing disease, explaining the increase in unintentional injuries. The 5.3-fold increase in intentional injuries during the weeks when patients are waiting for results of diagnostic procedures suggests that psychological stress is high during that period.

The researchers note that their results may underestimate the number of injuries, as the study did not include injuries that did not result in hospitalization or were fatal. Furthermore, because this was an observational study, firm conclusions on cause and effect cannot be made.

An accompanying editorial commented that the study indicates clinicians need to be more aware of the negative effects of a diagnosis on a patient’s health and well-being. “Patients cannot undo their diagnosis, but effective and empowering interventions could limit the extent to which they become undone by it,” concluded the editorial.2


1. Shen Q, Lu D, Schelin ME, et al. Injuries before and after diagnosis of cancer: nationwide register based study. BMJ. 2016 Aug 31. doi: 10.1136/bmj.14218. [Epub ahead of print]

2. Patients with cancer at heightened risk of injuries during diagnosis [news release]. EurekAlert! website. Accessed September 4, 2016.