Risk factors associated with suicide in adolescents and young adults (AYA) with cancer

Cancer Medicine

Jeremy Lewin¹  Sarah Heynemann¹  Sandun Silva²  Donovan Moncur³  Kate Thompson³  Madawa Jayawardana⁴ 

[1] Department of Medical Oncology Peter MacCallum Cancer Centre Melbourne Victoria Australia;Department of Statistics, Data Science and Epidemiology Swinburne University of Technology Hawthorn Victoria Australia;ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service Peter MacCallum Cancer Centre Melbourne Victoria Australia;Office of Cancer Research Peter MacCallum Cancer Centre Melbourne Victoria Australia;

关键词: adolescents and young adults;    cancer;    suicidality;    suicide;   

DOI  :  10.1002/cam4.4246

来源: DOAJ

【 摘 要 】

Abstract Background Higher rates of death by suicide are recognized both in individuals of any age with cancer and, separately, among adolescents and young adults (AYA) without cancer. Given this intersection, identifying risk factors associated with suicidal risk among AYA with cancer is critical. Objective To identify characteristics associated with suicide among AYA with cancer. Methods A retrospective analysis of AYA (aged 15–39) during 1975–2016 from the Surveillance, Epidemiology, and End Results database was conducted. Clinical and demographic factors associated with death by suicide among the AYA cancer population were compared to (i) US population normative data (standardized mortality ratios [SMRs]) and (ii) other AYA individuals with cancer (odds ratios). Results In total, 922 suicides were found in 500,366 AYA with cancer (0.18%), observed for 3,198,261 person‐years. The SMR for AYA with cancer was 34.1 (95% confidence interval [CI]: 31.4–36.9). Suicide risk was particularly high in females (SMR = 43.4, 95% CI: 37.2–50.4), unmarried persons (SMR = 50.6, 95% CI: 44.7–57.1), those with metastatic disease (SMR = 45.2, 95% CI: 33.1–60.3), or certain histological subtypes (leukemia, central nervous system, and soft tissue sarcoma). Risk generally reduced over time, however remained elevated ≥5 years following a cancer diagnosis (SMR > 5 years = 28.1, 95% CI: 25.4–31.0). When comparing those who died from suicide and those who did not, the following factors demonstrated significant associations: sex (males > females), race (White ethnicity > Black/other ethnicity), relationship status (never married > other), and disease stage (distant > localized). Conclusions Death due to suicide/non‐accidental injury is high compared to normative data, requiring increased awareness among health‐care providers, suicide risk monitoring in AYA, and appropriately tailored psychosocial interventions.

【 授权许可】

Unknown