In a study reported in Cancer, Osazuwa-Peters et al found that the mortality rate from suicide among head and neck cancer survivors was twice as high as the pooled rate in survivors of 19 other cancers considered in the study. Only the rate of suicide in pancreatic cancer survivors was higher than that in head and neck cancer survivors.
The study involved data from the Surveillance, Epidemiology, and End Results 18 registry database from 2000 to 2014 on the top 20 cancer sites in the database. The outcome of interest was suicide as a cause of death.
Risk of Suicide
Among 151,167 head and neck cancer survivors from 2000 to 2014, there were 404 suicides, representing a suicide rate of 63.4 per 100,000 person-years. Over the same period, there were 4,493 suicides among 4,219,097 cancer survivors, an incidence rate of 23.6 suicides per 100,000 person-years.
Compared with survivors of other cancers, the adjusted rate ratio (aRR) for suicide among head and neck cancer survivors was 1.97 (95% confidence interval [CI] = 1.77-2.19). Moreover, risk of suicide among head and neck cancer survivors increased from 2000–2004 to 2010–2014 (aRR = 1.27, 95% confidence interval [CI] = 1.16–1.38). The estimated rate of suicide in the U.S. general population was 17.4 per 1000,000 person-years.
Among the 20 cancers analyzed, only survivors of pancreatic cancer had a higher suicide rate than head and neck cancer survivors (86.4 suicides per 100,000 person-years). Among men, only pancreatic cancer survivors had a significantly higher risk of suicide than head and neck cancer survivors (aRR = 1.53), with survivors of lung/bronchus cancers and stomach cancers having rates similar to those of head and neck cancer survivors. Among women, suicide risk was highest for head and neck cancer survivors, with the next highest rate ratios being for survivors of lung/bronchus cancers and ovarian cancers.
The investigators concluded, “Although survival rates in cancer have improved because of improved treatments, the risk of death by suicide remains a problem for cancer survivors, particularly those with head and neck cancer.”
No specific funding was reported for this work.
Nosayaba Osazuwa-Peters, BDS, PhD, MPH, CHES, of St. Louis University Cancer Center, is the corresponding author for the Cancerarticle.
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