Timely symptom management and targeted psychosocial interventions are essential for the prevention of suicide in individuals with cancer, according to research published in JAMA Network is open.
Individuals diagnosed with cancer have an elevated risk of suicide compared to the general population. National estimates of suicide risk in this population are lacking, however, and knowledge about specific risk factors is limited. Therefore, the researchers designed a new study to provide contemporary estimates of cancer-related suicide risk and to identify the sociodemographic and clinical factors associated with suicide risk.
Previous studies have identified some risk factors, including male sex, old age, advanced stage at diagnosis, and rural residence. However, the researchers note that estimates in the United States were limited to surveillance, epidemiology, and end results program records from 13 or fewer states. In addition, these studies were not able to examine the contribution of some factors unique to the United States, such as residency status, insurance coverage, ethnicity, and socioeconomic status at the county level.
A population of individuals from 43 states diagnosed with cancer from January 1, 2000 to December 31, 2016 was followed through the end of 2016. Standardized mortality ratios were calculated and adjusted for age at death, sex, and ethnicity. , and ethnic groups to compare suicide risk in the cancer group versus the general US population. The main outcomes were the risk of suicidal death compared with the general population and the risk of suicidal death associated with sociodemographic and clinical factors among individuals with cancer.
According to the study, 16,771,397 individuals were identified with cancer. Of those, 50.9% were 65 or older at the time of diagnosis, 51.5% were male, 78.4% were non-Hispanic whites, and 0.1% died from suicide. The overall standardized death rate from suicide was 1.26, with a declining trend in 2000 to 1.16.
Compared to the general population, the researchers noted a higher risk of suicide in the cancer group across all sociodemographic groups. They also noted particularly high record-breaking death rates for Hispanic individuals, those with Medicaid insurance, those with Medicare insurance who are 64 or younger, and uninsured patients. In addition, the highest standardized mortality rate is observed in the first six months after cancer diagnosis.
Among people diagnosed with cancer, relatively higher suicide risks were observed for cancers with poor prognosis and high symptom burden in the first two years after diagnosis, including cancers of the oral cavity, pharynx, esophagus, stomach, brain, other nervous system, pancreas, and lung. After two years, individuals with cancers exposed to poor long-term quality of life, such as oropharyngeal cavity, leukemia, breast, uterine, and bladder cancers, were more likely to commit suicide.
Based on these findings, the researchers concluded that elevated suicide risks persist for cancer patients, despite a decreasing trend over the past two decades. Suicide risk varies according to sociodemographic and clinical factors, and timely symptom management and targeted psychosocial interventions are essential for suicide prevention in these patients.
Reference
Hu X, Ma J, Jemal A, et al. Risk of suicide among individuals diagnosed with cancer in the United States, 2000-2016. GammaNet is open. 2023; 6 (1): e2251863. doi: 10.1001/jamanetworkopen.2022.51863.
