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The hidden dangers of a cancer diagnosis

BMJ 2016; 354 doi: (Published 31 August 2016) Cite this as: BMJ 2016;354:i4446

Chinese translation


  1. Holly G Prigerson, professor of medicine1,
  2. Susan C Vaughan, assistant professor of clinical psychiatry2,
  3. Wendy G Lichtenthal, assisting attending psychologist3
  1. 1Center for Research on End-of-Life Care, Department of Medicine, Weill Cornell Medicine, New York, NY 10065, USA
  2. 2Department of Psychiatry, Columbia College of Physicians and Surgeons, New York, NY 10032, USA
  3. 3Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
  1. Correspondence to: H G Prigerson hgp2001{at}

Patients have a heightened risk of injury in the weeks before and after a diagnosis

No one can deny that medical advances have prolonged life and improved the human condition. Yet it is equally true that outcomes of medical encounters are neither universally beneficial nor benign. As long ago as 19 BC, Virgil wrote that it is often the case that “the disease worsens with the treatment.”1 In the linked paper, Shen and colleagues (doi:10.1136/bmj.i4218)2 extend this assertion to “the disease worsens with the diagnosis.” They sought to determine how a diagnosis of cancer, apart from the disease and its treatment, heightens the risk of injury before and after the diagnostic period. They hypothesized that injury secondary to a diagnosis results from both medical complications and psychosocial stress.

Shen and colleagues analysed hospital discharge diagnoses related to injury in over 720 000 patients with cancer in Sweden and compared a diagnostic period (the 16 weeks before and after a diagnosis) with a control period the year before diagnosis.2 …

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