Story at a glance
- Compared with those diagnosed in 2000, patients diagnosed in more recent years had significantly lower suicide risks.
- However, risks remain elevated compared with the general population.
- Socioeconomic, geographic and racial/ethnic factors all affected suicide risk.
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Individuals diagnosed with cancer between 2000 and 2016 had a 26 percent higher risk of suicide compared with the general population, new research shows.
Both insurance status and ethnicity contributed to the elevated risk, authors wrote. Those with poor prognosis at the time of diagnosis were at a heightened risk of suicide within two years of learning they had the disease. Patients who had cancers prone to long-term quality-of-life impairments were at a greater risk after these first two years.
However, the highest risk was seen within the first six months after a patient received a cancer diagnosis, where the risk was seven times greater than that of the general population.
Findings underscore the need for timely symptom management and targeted psychosocial interventions for suicide prevention in individuals diagnosed with cancer, researchers said.
“These require joint efforts by federal and state governments, as well as healthcare providers, to ensure comprehensive health insurance coverage for psycho-oncological, psychosocial, and palliative care, development of appropriate clinical guidelines for suicide risk screening, and inclusion of suicide prevention in survivorship care plans,” senior author Xuesong Han said in a release. Han is the scientific director of health services research at the American Cancer Society.
Although those diagnosed with cancer had consistently higher risks of suicide through the years studied, risks declined from 67 percent in 2000 to 16 percent in 2016. This decline occurred alongside increased use of psychosocial and palliative care and advances in cancer symptom management, authors explained.
Data from more than 16 million individuals with cancer living in 43 states were included in the analysis. Of these, more than half were aged 65 or older at the time of diagnosis.
A total of 20,792 cancer patients died from suicide during the study window. Suicide is a leading cause of death in the United States, and despite declines seen in the general population from 2019 to 2020, the latest data show rates rose once again in 2021.
In the current study, researchers found risks were elevated in Hispanic patients, those who receive insurance through Medicare and are under the age of 64, and in uninsured individuals. Patients insured through Medicaid or the Department of Veterans Affair also had higher suicide risks.
Patients living in less populated states like New Mexico, Nevada and Alaska were at a greater risk of suicide, a finding which could be related to suicide clusters among American Indian and Alaska Native communities.
“Hispanic and American Indian, Alaska Native, Asian, and Pacific Islander individuals with cancer were at substantially higher suicide risks than their peers without cancer, which points to potential barriers to health care resources, structural racism, and difficulties navigating health care systems among these populations,” authors noted.
In addition, males, white individuals, patients living in non-metropolitan counties and counties with high poverty rates had an increased risk of suicide.
“The overall decreasing trend in suicide risk suggests a positive role of the coinciding promotion of psychosocial and palliative care and advances in symptom control and pain management,” said lead author Xin Hu, a Ph.D. candidate at Emory University.
“But more needs to be done. Examining the associations of clinical factors such as cancer treatments as well as policy factors with suicide risk and evaluating psychosocial interventions are important areas for future research.”