Incidence of suicide among adolescent and young adult cancer patients: a population-based study

Pengcheng Yang,Lei Zhang,Xiaohua Hou

doi:10.1186/s12935-021-02225-y

Abstract

BackgroundAs the survival rates of cancer patients continue to increase, most cancer patients now die of non-cancer causes. Several studies have been showing elevated suicide rates among patients with cancer. However, no large-scale study has thoroughly assessed the risk of suicide among adolescent and young adult (AYA) patients with cancer. This study was conducted to characterize suicide mortality among AYA patients in the US and identify risk factors associated with a higher risk of suicide.MethodsPatients aged 15–39 years were residents of the US served by the Surveillance, Epidemiology, and End Results (SEER) program, who were diagnosed with cancers from 1973 to 2015.ResultsWe report that 981 of the 572,500 AYA patients with cancer committed suicide, for an age-, sex-, and race-adjusted suicide rate of 17.68/100,000 person-years. The rate of suicide was 14.33/100,000 person-years in the corresponding general population, giving a standardized mortality ratio (SMR) of 1.234 [95% confidence interval (CI) 1.159–1.313]. Higher suicide rates were associated with male sex, white race, unmarried state, distant tumor stage, and single primary tumor. AYA patients with otorhinolaryngologic, gonad, stomach, soft tissue, and nasopharyngeal cancer were at the greatest risk of suicide compared with those with other types of cancer. In older patients (≥ 40 years), the risk was highest in those with lung, stomach, oral cavity and pharynx, larynx, and bone malignancies. SMRs were highest in the first 5 years after diagnosis for most types of cancer.ConclusionAYA patients with cancer in the US have over 20% higher the incidence of suicide of the general population, and most suicides occurred in the first 5 years following diagnosis. Suicide rates vary among patients with cancers of different anatomic sites. Further examination of the psychological experience of these young patients with cancer, particularly that of those with certain types of cancer, is warranted.

Highlights

As the survival rates of cancer patients continue to increase, most patients with cancer die of noncancer causes [1]
This study aimed to present a contemporary analysis of the risk of suicide among AYA patients with cancer through the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) repository freely available to the public
In total, 981 suicides were identified in 572,500 AYA patients with cancer

Summary

Introduction

As the survival rates of cancer patients continue to increase, most patients with cancer die of noncancer causes [1]. It will become crucial to identify patients with cancer at elevated risk of suicide These populationbased studies have not distinguished between childhood, adolescent and young adults (AYA), and older adults, confounding the discrepancy of the incidence of suicide among these different age groups. AYA, 15–39 years old, whose physical, psychosocial, and psychical conditions differ from other age groups, are at an early stage in life when their education, career, and family life just start, and they have a long way to go in their lives. It is devastating for AYA, physically and mentally, to be diagnosed with cancer. This study was conducted to characterize suicide mortality among AYA patients in the US and identify risk factors associated with a higher risk of suicide

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