title: Suicide in women with gynecologic cancer.
abstract: OBJECTIVE
  To characterize the suicide rates among patients with gynecologic cancer in the Unites States and to identify factors associated with high suicide rates.
  
  
  METHODS
  Subjects with a diagnosis of gynecologic cancer were identified from the Surveillance, Epidemiology, and End Results (SEER) program for the period 1988-2007. Comparison with women in the general US population was based on WHO data 2005, matched for age in 10-year categories. Cox regression models were used to perform multivariate modeling for factors associated with suicide.
  
  
  RESULTS
  Among 252,235 patients followed for 1,207,278 person-years, the suicide rate was 8.3 per 100,000 person-years, with a standardized mortality ratio (SMR) of 1.4 (95% CI 1.2-1.7, p<0.001). The highest suicide rates were observed in patients with ovarian cancer and within the first year following diagnosis. Suicide risk was associated with younger age at diagnosis, high grade disease and absence of surgical intervention.
  
  
  CONCLUSIONS
  Patients with gynecologic cancer have an increased suicide risk when compared to the general population. Suicide rates vary by cancer site and time since diagnosis. Effective screening and appropriate treatment of psychosocial stress among women with gynecologic cancer are warranted.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA. mahdih@uw.edu
authors.forename: Haider
authors.initials: H
authors.lastname: Mahdi
authors.forename: Ron E
authors.initials: RE
authors.lastname: Swensen
authors.forename: Adnan R
authors.initials: AR
authors.lastname: Munkarah
authors.forename: Seine
authors.initials: S
authors.lastname: Chiang
authors.forename: Kayla
authors.initials: K
authors.lastname: Luhrs
authors.forename: David
authors.initials: D
authors.lastname: Lockhart
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D016016:Proportional Hazards Models; D018426:SEER Program; D013405:Suicide / Q000706:statistics & numerical data*