Trends in incidence and associated risk factors of suicide mortality among breast cancer patients

Psychooncology. 2018 May;27(5):1450-1456. doi: 10.1002/pon.4570. Epub 2017 Nov 7.

Abstract

Objective: Breast cancer patients are associated with an increased risk for committing suicide. The purpose of this study was to study the trends in the incidence of suicide mortality and identify pertinent risk factors among patients with breast cancer.

Methods: A retrospective examination of the Surveillance Epidemiology and End Results database between years 1973 and 2013 was performed.

Results: Overall, 474 128 patients were identified of which 773 had committed suicide. There were no significant differences in the incidence of suicide mortality over the last 3 decades (1984-1993: 0.14%, 1994-2003: 0.16%, 2004-2013: 0.17%, P = 0.173). On logistic regression, younger age (<30 y: OR 6.34, 95% CI: 1.98-20.33, P = 0.002; 30-49 y: OR 10.64, 95% CI: 7.97-14.2, P < 0.001; 50-69 y: OR 4.7, 95% CI: 3.64-6.07, P < 0.001), male sex (OR 4.34, 95% CI: 2.57-7.31, P < 0.001), nonwhite-nonblack race (OR 1.39, 95% CI: 1.01-1.91, P = 0.046), marital status (single: OR 1.35, 95% CI: 1.04-1.76, P = 0.024; separated/divorced/widowed: OR 1.25, 95% CI: 1.01-1.55, P = 0.043), undergoing surgery (OR 2.13, 95% CI: 1.23-3.67, P = 0.007), and short-time elapsed from diagnosis (first year: OR 4.67, 95% CI: 3.39-6.42, P < 0.001; second year: OR 2.35, 95% CI: 1.69-3.27, P < 0.001) were independent risk factors of suicide mortality.

Conclusions: There have been no identifiable improvements in preventing suicide mortality in the United States. Younger age, male sex, race, marital status, and undergoing surgery are independent risk factors for committing suicide, especially in the first year after diagnosis.

Keywords: SEER; breast; cancer; mortality; oncology; psycho-oncology; suicide.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Breast Neoplasms / psychology*
  • Female
  • Humans
  • Incidence
  • Male
  • Marital Status
  • Middle Aged
  • Population Surveillance / methods*
  • Retrospective Studies
  • Risk Factors
  • SEER Program
  • Sex Factors
  • Suicide / psychology
  • Suicide / statistics & numerical data*
  • Suicide / trends
  • United States / epidemiology