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      Suicide among cancer patients

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          Abstract

          Our purpose is to identify cancer patients at highest risk of suicide compared to the general population and other cancer patients. This is a retrospective, population-based study using nationally representative data from the Surveillance, Epidemiology, and End Results program, 1973-2014. Among 8,651,569 cancer patients, 13,311 committed suicide; the rate of suicide was 28.58/ 100,000-person years, and the standardized mortality ratio (SMR) of suicide was 4.44 (95% CI, 4.33, 4.55). The predominant patients who committed suicide were male (83%) and white (92%). Cancers of the lung, head and neck, testes, bladder, and Hodgkin lymphoma had the highest SMRs ( > 5-10) through the follow up period. Elderly, white, unmarried males with localized disease are at highest risk vs other cancer patients. Among those diagnosed at < 50 years of age, the plurality of suicides is from hematologic and testicular tumors; if > 50, from prostate, lung, and colorectal cancer patients.

          Abstract

          Cancer patients are at an increased risk of suicide: elderly, white, unmarried males with localized disease are at highest risk vs other cancer patients. Among those diagnosed at < 50 years of age, the plurality of suicides is from hematologic and testicular tumors; if > 50, from prostate, lung, and colorectal cancer patients.

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          Causes of death among cancer patients

          NG Zaorsky, TM Churilla, BL Egleston … (2016)
          The purpose of our study was to characterize the causes of death among cancer patients as a function of objectives: (i) calendar year, (ii) patient age, and (iii) time after diagnosis.
          Article 0 comments Cited 241 times – based on 0 reviews     Review now
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            Incidence of suicide in persons with cancer.

            Tomoko Misono, Mary Redman, Jesse Fann … (2008)
            The purpose of this study was to characterize suicide rates among patients with cancer in the United States and identify patient and disease characteristics associated with higher suicide rates. Prior studies, mostly in Europe, have suggested that patients with cancer may be at increased risk for suicide, but large cohort studies comparing patients with cancer with the general population have not been performed in the United States. Patients in the study were residents of geographic areas served by the Surveillance, Epidemiology, and End Results (SEER) program who were diagnosed with cancer from 1973 to 2002. Comparisons with the general US population were based on mortality data collected by the National Center for Health Statistics. This was a retrospective cohort study of suicide in persons with cancer. Among 3,594,750 SEER registry patients observed for 18,604,308 person-years, 5,838 suicides were identified, for an age-, sex-, and race-adjusted rate of 31.4/100,000 person-years. In contrast, the suicide rate in the general US population was 16.7/100,000 person-years. Higher suicide rates were associated with male sex, white race, and older age at diagnosis. The highest suicide risks were observed in patients with cancers of the lung and bronchus (standardized mortality ratio [SMR] = 5.74; 95% CI, 5.30 to 6.22), stomach (SMR = 4.68; 95% CI, 3.81 to 5.70), oral cavity and pharynx (SMR = 3.66; 95% CI, 3.16 to 4.22), and larynx (SMR = 2.83; 95% CI, 2.31 to 3.44). SMRs were highest in the first 5 years after diagnosis with cancer. Patients with cancer in the United States have nearly twice the incidence of suicide of the general population, and suicide rates vary among patients with cancers of different anatomic sites. Further examination of the psychological experience of patients with cancer, particularly that of patients with certain types of cancer, is warranted.
            Article 0 comments Cited 165 times – based on 0 reviews     Review now
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              Completed suicide after a suicide attempt: a 37-year follow-up study.

              Erkki Isometsä, Jaana Suokas, Jari Haukka … (2004)
              Attempted suicide is the strongest known predictor of completed suicide. However, suicide risk declines over time after an attempt, and it is unclear how long the risk persists. Risk estimates are almost exclusively based on studies of less than 10 years of follow-up. The authors followed a cohort of 100 consecutive self-poisoned patients in Helsinki in 1963, for whom forensically classified causes of death during the following 37 years were investigated. They found that suicides continued to accumulate almost four decades after the index suicide attempt. A history of a suicide attempt by self-poisoning indicates suicide risk over the entire adult lifetime.
              Article 0 comments Cited 145 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Nicholas G. Zaorsky:
                ORCID: http://orcid.org/0000-0002-4932-1986
                nicholaszaorsky@gmail.com
                Journal
                Journal ID (nlm-ta): Nat Commun
                Journal ID (iso-abbrev): Nat Commun
                Title: Nature Communications
                Publisher: Nature Publishing Group UK (London )
                ISSN (Electronic): 2041-1723
                Publication date (Electronic): 14 January 2019
                Publication date PMC-release: 14 January 2019
                Publication date Collection: 2019
                Volume: 10
                Electronic Location Identifier: 207
                Affiliations
                [1 ]ISNI 0000 0001 2097 4281, GRID grid.29857.31, Department of Radiation Oncology, , Penn State Cancer Institute, ; Hershey, PA 17033 USA
                [2 ]ISNI 0000 0004 0543 9901, GRID grid.240473.6, Department of Public Health Sciences, , Penn State College of Medicine, ; Hershey, PA 17033 USA
                [3 ]ISNI 0000000419368710, GRID grid.47100.32, Department of Therapeutic Radiology, , Yale School of Medicine, Smilow Cancer Hospital at Yale, ; 35 Park Street, New Haven, CT 06511 USA
                Author information
                http://orcid.org/0000-0002-4932-1986
                Article
                Publisher ID: 8170
                DOI: 10.1038/s41467-018-08170-1
                PMC ID: 6331593
                PubMed ID: 30643135
                SO-VID: 089f3e90-ecfc-4061-baa5-b9cab160ffc4
                Copyright © © The Author(s) 2019
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 10 July 2018
                Date accepted : 19 December 2018
                Categories
                Subject: Article
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                issue-copyright-statement © The Author(s) 2019

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