Suicide rates among patients with cancers of the digestive system
A partir des données des registres américains des cancers portant sur 856 293 patients atteints d'un cancer du système digestif sur la période 2000-2014, cette étude évalue les facteurs associés au risque de suicide, en fonction de la localisation anatomique de la maladie (881 suicides)
Objective : Previous studies have suggested that suicide rates are elevated among cancer patients relative to the general population. In this analysis, we comprehensively evaluated characteristics associated with higher suicide rates among patients with cancers of the digestive system. Methods : Using the United States (U.S.) Surveillance, Epidemiology, and End Results (SEER) database, we identified all patients diagnosed with digestive system cancers during 2000-2014. Patients were classified as having died from suicide if their cause of death in SEER was listed as “suicide and self-inflicted injury.” Suicide rates were compared to age-, sex-, and race-adjusted rates in the general population. Results : A total of 881 suicides were identified among 856,293 patients diagnosed with digestive system cancers. The suicide rate in this population was 32.8 per 100,000 person-years, and was nearly twice that in the general population (standardized mortality ratio [SMR]=1.91; 95% CI: 1.79, 2.04). Suicide rates were significantly elevated for all cancer sites, but were highest for esophageal (SMR=5.03), pancreatic (SMR=5.28), stomach (SMR=2.84), and liver (SMR=2.14) cancers. SMRs for suicide were highest within the first five years of diagnosis, and increased with age at diagnosis for all sites except colon and stomach. Conclusions : Patients with cancers of the digestive system have a higher incidence of suicide than the general population. Suicide rates among esophageal and pancreatic cancer patients are more than five times general population rates. The involvement of psychiatrists and other mental health professionals may be a critical component of cancer care for these high-risk patient subgroups.
Psycho-Oncology 2018