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Cancer patients at increased risk for suicide
contrast, and consistent with prior research, the risk of suicide did increase with psychiatric diagnoses, primarily affectiv
Last Updated: 2008-08-11 18:00:13 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Cancer patients often think about ending their lives and their suicide rate is roughly double that seen in the general population, according to the results of three studies appearing in the August 11th online issue of the Journal of Clinical Oncology.
In a survey of 2924 cancer outpatients at one regional cancer center, Dr. Jane Walker, from the Royal Edinburgh Hospital in the UK, and co-investigators found that 7.8% of subjects had thought they would be "better off dead" or had considered hurting themselves in some way in the last 2 weeks.
Emotional distress was the strongest predictor of suicidal thoughts, followed by substantial pain and older age, the report indicates.
"Management of emotional distress and pain should be a central aspect of cancer care," the investigators emphasize.
In another study, Dr. Stephanie Misono, from the University of Washington in Seattle, and her team assessed cancer-related suicide rates by analyzing data from the Surveillance, Epidemiology, and End Results program for nearly 3.6 million patients who were diagnosed with a malignancy from 1973 to 2002.
A total of 5,838 suicides occurred, yielding an adjusted rate of 31.4/100,000 person-years, which is nearly twice as high as the rate of 16.7/100,000 person-years seen in the general population.
Male gender, white race, and older age at diagnosis were all linked to an increased suicide risk. In terms of cancer types, lung cancers carried the highest suicide risk, followed by malignancies involving the stomach, oral cavity and pharynx, and larynx. The suicide risk was greatest within the first 5 years after diagnosis.
In a third study, Dr. Matthew Miller, from Harvard School of Public Health in Boston, and colleagues show that cancer is the only common medical condition that carries an elevated risk of suicide (OR = 2.3). The study included over 1300 patients with a variety of illnesses, such as diabetes, heart disease, and chronic lung disease.
In a related editorial, Dr. Timothy E. Quill, from the University of Rochester Medical Center in New York, comments that "lessening suffering of seriously ill patients though the diligent application of palliative measures and alleviating their aloneness and despair by maintaining an open, committed, receptive relationship may be the most important preventive measures with regard to suicide."
J Clin Oncol 2008;26.
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