Suicide rates in US cancer patients


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Stephanie Misono1,2, Noel S Weiss2,3, Jesse R Fann2,3, Mary Redman3, Bevan Yueh1, 2,3

1VA Puget Sound Health Care System, Seattle, USA, 2University of Washington, Seattle, USA, 3Fred Hutchinson Cancer Research Center, Seattle, USA

Abstract

Suicide rates in US cancer patients

Aim

Prior studies, mostly in Europe, have suggested that cancer patients may be at increased risk for suicide, but large cohort studies comparing cancer patients with the general population have not been performed in the U.S.. We aimed to characterize suicide rates among U.S. cancer patients and identify patient and disease characteristics associated with higher suicide rates.

Method

Retrospective cohort study of suicide in residents of geographic areas served by the Surveillance, Epidemiology, and End Results (SEER) program who were diagnosed with cancer from 1973 to 2002. Comparisons to U.S. general population were based on mortality data collected by the National Center for Health Statistics.

Results

Among 3,594,750 SEER registry patients followed 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 gender, white race, and older age. The highest suicide risks were observed in patients with cancers of the lung and bronchus (SMR 5.74 [95% CI: 5.30, 6.22]), stomach (SMR 4.68 [3.81, 5.70], oral cavity and pharynx (SMR 3.66 [3.16, 4.22]), and larynx (SMR 2.83 [2.31, 3.44]). SMRs were highest in the first five years following cancer diagnosis.

Conclusion

U.S. cancer patients have nearly twice the incidence of suicide of the general population, and suicide rates vary across anatomic sites. Further research is needed to examine risk factors and preventive measures for suicide in patients with cancer, particularly in patients with certain types of cancer.