Deaths and major biographical events: a study of all cancer deaths in Germany from 1995 to 2009

OBJECTIVE: To determine if people dying from cancer are able to prolong their own life in order to experience a certain biographical event, or whether the appearance of such an occasion leads to increased deaths before the event. METHODS: We compared numbers of cancer deaths during a period of 1 week before and after biographically important occasions, which were birthday, Christmas and Easter. As a psychogenic postponement or hastening of death is most likely in chronic diseases (as opposed to accidents or cardiovascular events), we included cancer deaths only. We estimated relative risks (RRs) with their corresponding Bonferroni corrected CIs to assess effects of biographical events. All registered cancer deaths in Germany from 1995 to 2009 were included (3 257 520 individual deaths). Numbers of deaths were corrected for seasonality. RESULTS: Considering all cases, there were noticeably more deaths than expected in the week preceding Christmas, leading to an RR of dying after the event of 0.987 (CI 0.978 to 0.997). Estimates indicating a hastening of death were consistent over several subgroups. Other occasions showed inconsistent results, especially there was no convincing postponement effect in our data. CONCLUSIONS: While there is no evidence of different death numbers before and after Easter and birthdays, the appearance of Christmas seems to increase deaths.