The risk of suicide is more than four times higher among Americans with cancer than those without the disease, a new study finds.
"Even though cancer is one of the leading causes of death in the United States, most cancer patients do not die from cancer, the patients usually die of another cause," said researcher Nicholas Zaorsky, a radiation oncologist in the Penn State Cancer Institute.
"There are multiple competing risks for death, and one of them is suicide. Distress and depression can arise from cancer diagnosis, treatment, financial stress and other causes. Ultimately, distress and depression may lead to suicide. Our goal was to quantify the risk of suicide among cancer patients," Zaorsky said in a Penn State news release.
The suicide risk among cancer patients was highest for white males; people diagnosed at a younger age; and those with lung, head and neck, testicular cancer, and lymphomas. But the study did not prove that a cancer diagnosis actually caused suicide risk to rise.
The findings come from an analysis of data on 8.6 million US cancer patients diagnosed with invasive cancer – which is cancer that's spread from its original location into surrounding tissue – between 1973 and 2014.
The investigators found that 0.15% of the patients died by suicide, a rate more than four times higher than in the general population.
While the risk of suicide among most cancer patients fell within five years after diagnosis, the risk remained high for those with Hodgkin lymphoma and testicular cancer, the findings showed.
The study, published 14 January in Nature Communications, shows the need for a comprehensive approach to cancer care, according to the researchers.
While there have been significant advances in treating cancer, less attention has been paid to the mental and emotional impacts of the disease, Zaorsky noted.
"The interesting thing we found was that it does seem to matter at what age a patient is diagnosed, and what type of cancer that person has," he said.
"Treatments for some cancers – like leukaemia and testicular cancer among adolescents and young adults, for example – can decrease a patient's fertility, and that seems to be one of the risks for suicide in the long term," Zaorsky explained.
"In contrast," he continued, "elderly patients who are diagnosed with lung, prostate, and head and neck cancers, are at an increased risk of suicide for the remainder of their life."
These findings "could be helpful while developing guidelines and strategies for how and when to screen cancer patients for depression and distress," Zaorsky said. "For example, aiming suicide-prevention strategies at older patients and those with certain cancers – such as prostate, lung, leukaemias and lymphomas – may be beneficial."
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