特定的临床事件会降低预期寿命，并需要重新评估患者的治疗。描述与癌症诊断和临终生活相关的药物变化，并强调这种描述所面临的挑战和局限性。从所有丹麦2型糖尿病患者的队列中，我们使用倾向评分将2000年至2021年期间出现癌症的患者（n=41,745）与无癌症的患者（n=166,994）进行匹配。我们描述了他们从癌症诊断到死亡期间的药物使用情况。在癌症组，1年和5年的死亡率分别为51%和86%，而非癌症组分别为13%和59%。与癌症诊断和死亡相关的症状性药物（例如阿片类药物、苯二氮卓类药物）的使用增加了（每100个患者月增加10-60种新药物），而预防性药物的使用减少了（使用者减少了5-30%）。与诊断相关的变化主要发生在存活时间较短的患者（<2年）。相反，在临终前一年发生的变化与生存阶段的依赖程度较小，并且在最后几个月中有超过60%的患者使用了预防性药物。与癌症诊断相关的药物变化频繁，并与生存长度相关。结果展示了将分析结果锚定在事件或死亡上的挑战和有限的临床实用性。前者通过对具有完全不同疾病发展过程的患者之间的变化进行平均来削弱了结果，而后者则利用了医生不可获得的信息。尽管临终前药物变化很常见，但预防性药物通常会使用至死亡。©2023. 作者。

Certain clinical events reduce life expectancy and necessitate a reassessment of patient treatment.To describe medication changes in relation to a cancer diagnosis and the end of life and to highlight challenges and limitations with such descriptions.From a cohort with all Danish patients with type 2 diabetes, we matched patients with incident cancer during 2000-2021 (n = 41,745) with patients without cancer (n = 166,994) using propensity scores. We described their medication usage from cancer diagnosis until death.The 1- and 5-year mortality were 51% and 86%, respectively, in the cancer group, and 13% and 59% in the non-cancer group. In relation to cancer diagnosis and death, the use of symptomatic medications (e.g., opioids, benzodiazepines) increased (10-60 incident medications per 100 patient-months), and the use of preventive medications (e.g., antihypertensives, statins) decreased (5-30% fewer users). The changes in relation to the diagnosis were driven by patients with short observed lengths of survival (< 2 years). In contrast, changes occurring within a year before death were less dependent on survival strata, and > 60% used preventive medications in their last months.Medication changes in relation to a cancer diagnosis were frequent and correlated to the length of survival. The results showcase the challenges and limited clinical utility of anchoring analyses on events or death. While the former diluted the results by averaging changes across patients with vastly different clinical courses, the latter leveraged information unavailable to the treating clinicians. While medication changes were common near death, preventive medications were often used until death.© 2023. The Author(s).