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Risk of Suicide After Cancer Diagnosis in England

Henson, Katherine E ; Brock, Rachael ; Charnock, James ; Wickramasinghe, Bethany ; Will, Olivia ; Pitman, Alexandra

Archives of general psychiatry, 2019-01, Vol.76 (1), p.51-60 [Periódico revisado por pares]

United States: American Medical Association

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Título:
Risk of Suicide After Cancer Diagnosis in England
Autor: Henson, Katherine E ; Brock, Rachael ; Charnock, James ; Wickramasinghe, Bethany ; Will, Olivia ; Pitman, Alexandra
Assuntos: Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cancer ; England - epidemiology ; Esophageal Neoplasms - diagnosis ; Esophageal Neoplasms - psychology ; Female ; Humans ; Lung Neoplasms - diagnosis ; Lung Neoplasms - psychology ; Male ; Medical diagnosis ; Mesothelioma - diagnosis ; Mesothelioma - psychology ; Middle Aged ; Neoplasms - diagnosis ; Neoplasms - psychology ; Online First ; Original Investigation ; Pancreatic Neoplasms - diagnosis ; Pancreatic Neoplasms - psychology ; Risk Factors ; Stomach Neoplasms - diagnosis ; Stomach Neoplasms - psychology ; Suicide - psychology ; Suicide - statistics & numerical data ; Suicides & suicide attempts ; Young Adult
É parte de: Archives of general psychiatry, 2019-01, Vol.76 (1), p.51-60
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: IMPORTANCE: A diagnosis of cancer carries a substantial risk of psychological distress. There has not yet been a national population-based study in England of the risk of suicide after cancer diagnosis. OBJECTIVES: To quantify suicide risk in patients with cancers in England and identify risk factors that may assist in needs-based psychological assessment. DESIGN, SETTING, AND PARTICIPANTS: Population-based study using data from the National Cancer Registration and Analysis Service in England linked to death certification data of 4 722 099 individuals (22 million person-years at risk). Patients (aged 18-99 years) with cancer diagnosed from January 1, 1995, to December 31, 2015, with follow-up until August 31, 2017, were included. EXPOSURES: Diagnosis of malignant tumors, excluding nonmelanoma skin cancer. MAIN OUTCOMES AND MEASURES: All deaths in patients that received a verdict of suicide or an open verdict at the inquest. Standardized mortality ratios (SMRs) and absolute excess risks (AERs) were calculated. RESULTS: Of the 4 722 099 patients with cancer, 50.3% were men and 49.7% were women. A total of 3 509 392 patients in the cohort (74.3%) were aged 60 years or older when the diagnosis was made. A total of 2491 patients (1719 men and 772 women) with cancer died by suicide, representing 0.08% of all deaths during the follow-up period. The overall SMR for suicide was 1.20 (95% CI, 1.16-1.25) and the AER per 10 000 person-years was 0.19 (95% CI, 0.15-0.23). The risk was highest among patients with mesothelioma, with a 4.51-fold risk corresponding to 4.20 extra deaths per 10 000 person-years. This risk was followed by pancreatic (3.89-fold), esophageal (2.65-fold), lung (2.57-fold), and stomach (2.20-fold) cancer. Suicide risk was highest in the first 6 months following cancer diagnosis (SMR, 2.74; 95% CI, 2.52-2.98). CONCLUSIONS AND RELEVANCE: Despite low absolute numbers, the elevated risk of suicide in patients with certain cancers is a concern, representing potentially preventable deaths. The increased risk in the first 6 months after diagnosis may indicate an unmet need for psychological support. The findings of this study suggest a need for improved psychological support for all patients with cancer, and attention to modifiable risk factors, such as pain, particularly in specific cancer groups.
Editor: United States: American Medical Association
Idioma: Inglês

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Risk of Suicide After Cancer Diagnosis in England

Henson, Katherine E ; Brock, Rachael ; Charnock, James ; Wickramasinghe, Bethany ; Will, Olivia ; Pitman, Alexandra

United States: American Medical Association

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