1066Increased Risk of Suicide among Cancer Survivors Who Developed a Second Primary Malignancy. (2nd September 2021)

• Record Type: Journal Article
• Authors: Yang, Huazhen; Wang, Chengshi; Lu, Donghao; Song, Huan
• Is Part Of: International journal of epidemiology. Volume 50(2021)Supplement 1
• Publication Date: 2021-09-02
• Subjects: Epidemiology -- Periodicals; 614.4
• DOI: 10.1093/ije/dyab168.732
• Languages: English
• ISSNs: 0300-5771

Abstract

Abstract: Background: Cancer diagnosis entails substantial psychological distress and is associated with dramatically increased risks of suicide and psychiatric disorders. However, little is known about the suicide risk among cancer survivors who developed a second primary malignancy (PCa-2). Methods: Using the Surveillance, Epidemiology, and End Results database, we conducted a population-based cohort study, including 7, 169, 704 patients with first primary malignancy (PCa-1) and 686, 174 PCa-2 patients diagnosed from January 1, 1975, through December 31, 2016. Compared with patients with PCa-1, we measured the hazard ratios (HRs) of completed suicide after receiving a PCa-2 diagnosis, using Cox proportional hazard models. Results: 10, 938 and 937 completed suicides were identified among PCa-1 and PCa-2 patients, respectively. The HR of suicide deaths was 1.24 [95% confidence interval (CI), 1.15-1.32] after a PCa-2 diagnosis, compared with PCa-1 patients (adjusted for demographic factors, state, and tumor characteristic). The risk elevation was most pronounced when PCa-2 was prostate cancer (HR 1.37, 95% CI 1.18-1.60); and PCa-2 patients diagnosed between 60 to 75 years old had highest increased relative risk of suicide (HR 1.35, 95% CI 1.23-1.49). Conclusions: Compared with patients with first primary cancer, cancer survivors receiving a PCa-2 diagnosis, particularly of prostate cancer or at age 60-75, are at increased risk of suicide. These findings emphasize the need to support and carefully monitor cancer survivors for PCa-2. Key messages: Patients with PCa-2 are at a higher risk of suicide compared with patients with PCa-1, especially for PCa-2 diagnosed at age 60 to 75 or PCa-2 of prostate.