MP9-10 FACTORS ASSOCIATED WITH SUICIDE IN PATIENTS WITH GENITOURINARY MALIGNANCIES

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes II1 Apr 2015MP9-10 FACTORS ASSOCIATED WITH SUICIDE IN PATIENTS WITH GENITOURINARY MALIGNANCIES Zachary Klaassen, Rita P. Jen, John M. DiBianco, Lael Reinstatler, Qiang Li, Rabii Madi, Ronald W. Lewis, Arthur M. Smith, Durwood E. Neal, Jr., Kelvin A. Moses, and Martha K. Terris Zachary KlaassenZachary Klaassen More articles by this author , Rita P. JenRita P. Jen More articles by this author , John M. DiBiancoJohn M. DiBianco More articles by this author , Lael ReinstatlerLael Reinstatler More articles by this author , Qiang LiQiang Li More articles by this author , Rabii MadiRabii Madi More articles by this author , Ronald W. LewisRonald W. Lewis More articles by this author , Arthur M. SmithArthur M. Smith More articles by this author , Durwood E. Neal, Jr.Durwood E. Neal, Jr. More articles by this author , Kelvin A. MosesKelvin A. Moses More articles by this author , and Martha K. TerrisMartha K. Terris More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.370AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Approximately 70% of all suicides in patients >60 years of age are attributed to physical illness, with higher rates in patients with cancer. The purpose of this study was to characterize suicide rates among patients with genitourinary cancer and identify factors associated with suicide in this specific cohort. METHODS Patients with prostate, bladder, kidney, testis and penile cancer were identified between 1988–2010 from the SEER database. Contingency tables of suicide rates and standardized mortality ratios (SMR) and 95% CIs were calculated for each anatomic site. Subsequently, multivariable logistic regression models were performed to generate odds ratios (OR) for the identification of factors associated with suicide for each malignancy. RESULTS There were 2,268 suicides identified among 1,239,522 persons with genitourinary malignancy observed for 7,307,377 person-years. Overall, the SMRs for patients with cancer were: prostate 1.37 (95%CI 0.99-1.86), bladder 2.71 (95%CI 2.02-3.62), kidney 1.86 (95%CI 1.32-2.62), testis 1.23 (95%CI 0.88-1.73), and penile 0.95 (95%CI 0.65-1.35). Patients with prostate cancer had an increase in the incidence of suicide over time, with the highest incidence at 15+ years after diagnosis (SMR 1.84, 95%CI 1.39-2.41). Patients with bladder cancer had the highest incidence in the first 5 years after diagnosis (SMR 3.05, 95%CI 2.26-3.96). On multivariable analysis, male sex was associated with odds of suicide among patients with bladder cancer (OR 6.63, 95%CI 4.29-10.25), and kidney cancer (OR 4.98, 95%CI 2.96-8.37). Increasing age was associated with suicide for patients with prostate (OR 1.06, 95%CI 1.06-1.07), bladder (OR 1.03, 95%CI 1.03-1.04) and testis cancer (OR 1.03, 95%CI 1.00-1.05). Distant disease was associated with suicide in patients with prostate (OR 2.82, 95%CI 2.12-3.75), bladder (OR 5.43, 95%CI 2.51-11.76) and kidney cancer (OR 2.89, 95%CI 1.65-5.04). For all malignancies except penile cancer, non-married status was associated with increased likelihood of suicide (OR range 1.65-2.81), most notably for bladder cancer (OR 2.81, 95%CI 1.97-4.01). African-Americans were less likely to commit suicide compared to Caucasians with prostate (OR 0.34, 95%CI 0.26-0.44), bladder (OR 0.46, 95%CI 0.23-0.92) and kidney cancer (OR 0.26, 95%CI 0.10-0.72). CONCLUSIONS Suicide in patients with genitourinary malignancies poses a significant public health dilemma, especially among men, the elderly, and those with more aggressive disease. Clinicians at all levels of health care should be aware of risk factors for suicide in these patients. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e105-e106 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zachary Klaassen More articles by this author Rita P. Jen More articles by this author John M. DiBianco More articles by this author Lael Reinstatler More articles by this author Qiang Li More articles by this author Rabii Madi More articles by this author Ronald W. Lewis More articles by this author Arthur M. Smith More articles by this author Durwood E. Neal, Jr. More articles by this author Kelvin A. Moses More articles by this author Martha K. Terris More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...