Cancer tied to suicide risk, particularly in first 4 years

  • Klaassen Z & al.
  • Cancer
  • 25 Apr 2019

  • International Clinical Digest
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Takeaway

  • Patients with cancer were significantly more likely to die of suicide than people without cancer, especially within the first 50 months of diagnosis.
  • This risk was greatest among patients with advanced disease and those with no history of psychiatric conditions requiring emergency department visits or hospital admissions.

Why this matters

  • Prior studies failed to account for the potential role of prior psychiatric diagnosis.

Study design

  • 676,470 patients diagnosed with prostate, breast, colorectal, melanoma, lung, bladder, endometrial, thyroid, kidney, or oral cancer and 2,152,682 matched noncancer control patients.
  • Funding: Canadian Urological Association-Canadian Urologic Oncology Group-Astellas grant; Institute for Clinical Evaluative Sciences. 

Key results

  • Among patients with cancer and matched control patients, the suicide rate was 8.2 and 11.4 per 1000 person-years of follow-up, respectively.
  • Cancer was tied to a higher overall risk for suicidal death (HR, 1.34; 95% CI, 1.22-1.48), driven by the first 50 months (HR, 1.60; 95% CI, 1.42-1.81).
  • The effect was driven by patients with no history of psychiatric care or only outpatient care, as well as those with advanced malignancies.
  • Suicide risk was statistically significant in lung cancer (HR, 2.49; 95% CI, 1.98-3.13), colorectal cancer (HR, 1.58; 95% CI, 1.27-1.96), bladder cancer (HR, 1.73; 95% CI; 1.14-2.62), and oral cancer (HR, 2.55; 95% CI, 1.59-4.12).

Limitations

  • Retrospective study.