title: Incidence of Suicide in Patients With Head and Neck Cancer.
abstract: OBJECTIVE
  Suicide rates among patients with cancer in the US are significantly higher than those of the general population. To our knowledge, large cohort studies examining suicide rates among patients with head and neck cancer have not been performed.
  
  
  OBJECTIVE
  To identify incidence rate, trends, and risk factors of suicide in patients with cancer of the head and neck.
  
  
  METHODS
  This was a retrospective cohort study of geographic areas served by the Surveillance, Epidemiology, and End Results (SEER) program. In total, 350,413 cases of patients with head and neck cancer were recorded within the SEER registry between 1973 and 2011. Data analyses were performed in 2014. Incidence data were calculated from the subset of that population that had the cause of death category coded as "suicide and self-inflicted injury."
  
  
  METHODS
  Patients diagnosed as having a primary cancer of the head and neck region.
  
  
  METHODS
  Influence of demographic factors, anatomic site of tumor, disease stage, and time since diagnosis on risk for suicide.
  
  
  RESULTS
  Among 350,413 SEER registry patients with head and neck cancer, observed for 2,263,376 person-years, 857 suicides were identified with an age-, sex-, and race-adjusted suicide rate of 37.9/100,000 person-years. In contrast, the US general population suicide rate was 11.8 per 100,000 person-years. Suicide rates were higher in those treated with radiation alone (standardized mortality ratio [SMR], 5.12; 95% CI, 3.83-6.41) compared with those treated with surgery alone (SMR, 2.57; 95% CI, 1.66-3.49). The highest suicide risk was seen in patients with cancers of the hypopharynx (SMR, 13.91; 95% CI, 11.78-16.03) and larynx (SMR, 5.48; 95% CI, 4.14-6.81).
  
  
  CONCLUSIONS
  Patients with head and neck cancer have more than 3 times the incidence of suicide compared with the general US population. Furthermore, suicide rates were highest among those with cancers of the larynx and hypopharynx.
authors.affiliation: Medical student at Rutgers New Jersey Medical School, Newark.
authors.forename: David
authors.initials: D
authors.lastname: Kam
authors.affiliation: medical student at Rutgers University Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Andrew
authors.initials: A
authors.lastname: Salib
authors.affiliation: Medical student at Rutgers New Jersey Medical School, Newark.
authors.forename: George
authors.initials: G
authors.lastname: Gorgy
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark.
authors.forename: Tapan D
authors.initials: TD
authors.lastname: Patel
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark.
authors.forename: Eric T
authors.initials: ET
authors.lastname: Carniol
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark4Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark5Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey.
authors.forename: Jean Anderson
authors.initials: JA
authors.lastname: Eloy
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark5Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark.
authors.forename: Soly
authors.initials: S
authors.lastname: Baredes
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark.
authors.forename: Richard Chan Woo
authors.initials: RC
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D018426:SEER Program; D013405:Suicide / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology