title: Increased suicide risk in cancer patients in Tyrol/Austria.
abstract: OBJECTIVE
  To investigate whether suicide risk in Tyrol/Austria was increased for cancer patients as compared to the general population and whether subgroups at excess risk could be defined.
  
  
  METHODS
  Cohort design based on all malignant cancer cases diagnosed in Tyrol between 1991 and 2010 and excluding nonmelanoma skin cancer. Entry date was date of diagnosis of the index cancer; exit date was either date of suicide or date of death for reasons other than suicide or end of follow-up (Dec 31, 2011). Standardized mortality ratios (SMRs) were computed in the classical way after adjustment for sex, age and year of follow-up.
  
  
  RESULTS
  For all cancer sites except nonmelanoma skin cancer, we observed a SMR of 1.86 [95% confidence interval (CI), 1.57-2.19]. Suicide risk was greatest during the first 6 months after diagnosis with an SMR of 4.74 (95% CI, 3.27-6.66) and was more than fivefold in cases with advanced Stage IV. We observed the greatest excess risk for suicide in patients with head and neck cancers (13 suicides; SMR, 4.73; 95% CI, 2.52-8.09) and lung cancer (14 suicides; SMR, 4.16; 95% CI, 2.27-6.98).
  
  
  CONCLUSIONS
  In our study population in Tyrol/Austria, we observed a twofold suicide risk in cancer patients as compared with the general population, with the excess risk concentrated in the period shortly after diagnosis and in patients with poor prognosis. Therefore, psychooncological care should be intensified in this group of patients.
authors.affiliation: Department of Clinical Epidemiology of the Tyrolean State Hospitals Ltd., Cancer Registry of Tyrol, Anichstrasse 35, A-6020 Innsbruck, Austria; Department of Public Health and HTA, UMIT, Hall/Tyrol, Austria. Electronic address: willi.oberaigner@iet.at.
authors.forename: Willi
authors.initials: W
authors.lastname: Oberaigner
authors.affiliation: Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria. Electronic address: barbara.sperner-unterweger@i-med.ac.at.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sperner-Unterweger
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria. Electronic address: michael.fiegl@tilak.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Fiegl
authors.affiliation: Department of Clinical Epidemiology of the Tyrolean State Hospitals Ltd., Cancer Registry of Tyrol, Anichstrasse 35, A-6020 Innsbruck, Austria; Department of Public Health and HTA, UMIT, Hall/Tyrol, Austria.
authors.forename: Sabine
authors.initials: S
authors.lastname: Geiger-Gritsch
authors.affiliation: Department of Psychiatry and Psychotherapy, University Teaching Hospital Hall, Hall i.T., Austria. Electronic address: christian.haring@tilak.at.
authors.forename: Christian
authors.initials: C
authors.lastname: Haring
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D012306:Risk; D013405:Suicide / Q000706:statistics & numerical data*
keywords: Cancer; Cancer registry; Population-based study; Suicide; Suicide risk