Risk factors associated with suicide in adolescents and young adults (AYA) with cancer.
adolescents and young adults
cancer
suicidality
suicide
Journal
Cancer medicine
ISSN: 2045-7634
Titre abrégé: Cancer Med
Pays: United States
ID NLM: 101595310
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
revised:
30
07
2021
received:
19
05
2021
accepted:
10
08
2021
pubmed:
30
9
2021
medline:
11
3
2022
entrez:
29
9
2021
Statut:
ppublish
Résumé
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. To identify characteristics associated with suicide among AYA with cancer. 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). 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). 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.
Sections du résumé
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.
Identifiants
pubmed: 34586755
doi: 10.1002/cam4.4246
pmc: PMC8525084
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
7339-7346Informations de copyright
© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
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