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Increased Risk of Suicide among Cancer Survivors Who Developed a Second Malignant Neoplasm.

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机构： [1]West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China. [2]Med-X Center for Informatics, Sichuan University, Chengdu, China. [3]Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. [4]Laboratory of Molecular Diagnosis of Cancer, Clinical Research Center for Breast, West China Hospital, Sichuan University, Chengdu, China. [5]Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden. [6]Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA. [7]Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.

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Cancer diagnosis entails substantial psychological distress and is associated with dramatically increased risks of suicidal behaviors. However, little is known about the suicide risk among cancer survivors who developed a second malignant neoplasm (SMN).Using the Surveillance, Epidemiology, and End Results database, we conducted a population-based cohort study involving 7,824,709 patients with first malignant neoplasm (FMN). We measured the hazard ratios (HRs) of suicide death after receiving a SMN diagnosis using Cox proportional hazard models, as compared with patients with FMN. The comparison with the US population was achieved by calculating standardized mortality ratios (SMRs).Totally 685,727 FMN patients received a diagnosis of SMN during follow-up, and we in total identified 10,930 and 937 suicide deaths among FMN and SMN patients, respectively. The HR of suicide deaths was 1.23 (95% confidence interval (CI), 1.14-1.31) after a SMN diagnosis, compared with FMN patients, after adjusting for sociodemographic factors, tumor characteristics, and cancer treatment. As compared with the general population, while both SMN and FMN patients suffered an increased risk of suicide deaths, the excess risk was higher among SMN patients than FMN patients (age-, sex-, and calendar-year-adjusted SMR 1.65 (95% CI 1.54-1.75) vs. 1.29 (95% CI 1.26-1.31); P difference < 0.0001). Notably, across different time periods, we observed the greatest risk elevation during the first 3 months after a cancer diagnosis.Compared with either patients with FMN or the general population, cancer survivors who received a SMN diagnosis were at increased risk of suicide death. The risk elevation was most prominent soon after the cancer diagnosis, highlighting the necessity of providing timely psychological support to cancer survivors with a SMN.Copyright © 2022 Huazhen Yang et al.

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大类 | 3 区工程技术

小类 | 3 区数学与计算生物学 4 区神经科学

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影响因子： 0 最新[2023版] 0 最新五年平均 3.12 出版当年[2021版] 0 出版当年五年平均 3.12 出版前一年[2021版]

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第一作者机构： [1]West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China. [2]Med-X Center for Informatics, Sichuan University, Chengdu, China.

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通讯机构： [1]West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China. [2]Med-X Center for Informatics, Sichuan University, Chengdu, China. [5]Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden. [6]Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA. [7]Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.

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