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Suicide risk among cancer survivors: Head and neck versus other cancers.

  • Osazuwa-Peters, Nosayaba1, 2, 3
  • Simpson, Matthew C1
  • Zhao, Longwen3
  • Boakye, Eric Adjei4
  • Olomukoro, Stephanie I5
  • Deshields, Teresa6
  • Loux, Travis M3
  • Varvares, Mark A7
  • Schootman, Mario3
  • 1 Department of Otolaryngology-Head and Neck Surgery, St. Louis University School of Medicine St. Louis, Missouri.
  • 2 St. Louis University Cancer Center, St. Louis, Missouri.
  • 3 Department or Epidemiology and Biostatistics, St. Louis University College for Public Health and Social Justice, St. Louis, Missouri.
  • 4 St. Louis University Center for Outcomes Research (SLUCOR), St. Louis, Missouri.
  • 5 Department of Internal Medicine, St. Louis University School of Medicine, St. Louis, Missouri.
  • 6 Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
  • 7 Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
Published Article
Wiley (John Wiley & Sons)
Publication Date
Oct 15, 2018
DOI: 10.1002/cncr.31675
PMID: 30335190


Cancer survivors face psychosocial issues that increase their risk of suicide. This study examined the risk of suicide across cancer sites, with a focus on survivors of head and neck cancer (HNC). The Surveillance, Epidemiology, and End Results 18-registry database (from 2000 to 2014) was queried for the top 20 cancer sites in the database, including HNC. The outcome of interest was suicide as a cause of death. The mortality rate from suicide was estimated for HNC sites and was compared with rates for 19 other cancer sites that were included in the study. Poisson regression was used to estimate adjusted rate ratios (aRRs) and 95% confidence intervals (CIs) for 1) HNC versus non-HNC sites (the other 19 cancer sites combined), and 2) HNC versus each individual cancer site. Models were stratified by sex, controlling for race, marital status, age, year, and stage at diagnosis. There were 404 suicides among 151,167 HNC survivors from 2000 to 2014, yielding a suicide rate of 63.4 suicides per 100,000 person-years. In this timeframe, there were 4493 suicides observed among 4219,097 cancer survivors in the study sample, yielding an incidence rate of 23.6 suicides per 100,000 person-years. Compared with survivors of other cancers, survivors of HNC were almost 2 times more likely to die from suicide (aRR, 1.97; 95% CI, 1.77-2.19). There was a 27% increase in the risk of suicide among HNC survivors during the period from 2010 to 2014 (aRR, 1.27; 95% CI, 1.16-1.38) compared with the period from 2000 to 2004. Although survival rates in cancer have improved because of improved treatments, the risk of death by suicide remains a problem for cancer survivors, particularly those with HNC. © 2018 American Cancer Society.

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