Holidays, birthdays, and postponement of cancer death

Abstract

Context: Articles in the medical literature and lay press have supported a belief that individuals, including those dying of cancer, can temporarily postpone their death to survive a major holiday or other significant event, but results and effects have been variable.

Objective: To determine whether, for the patient dying of cancer, a "death takes a holiday" effect showing a reduction in deaths in the week before a significant event was associated with Christmas, the US holiday of Thanksgiving, or the date of the individual's birthday.

Design, setting, and subjects: Analysis of death certificate data for all 1,269,474 persons dying in Ohio from 1989-2000, including 309,221 persons dying with cancer noted as the leading cause of death.

Main outcome measure: We measured the total number of cancer deaths in the 2 weeks centered on the event of interest and the proportion of these deaths that occurred in the week before the event to determine whether this proportion was significantly different from 0.5 by using an exact binomial test.

Results: The proportion of persons dying of cancer in the week before Christmas, Thanksgiving, and the individual's birthday was not significantly different from the proportion dying in the week after the event (P = .52, .26, and .06, respectively). However, among black individuals there was an increase in cancer deaths in the week before Thanksgiving (P = .01), whereas women showed an increase in cancer deaths in the week before their birthday (P = .05). There was no statistically significant excess of deaths in the postevent week in any subgroup.

Conclusion: We found no evidence, in contrast to previous studies, that cancer patients are able to postpone their deaths to survive significant religious, social, or personal events.