Suicide in patients with gastric cancer: a population-based study.
OBJECTIVE
We conducted this study to examine the rate of suicide in patients with gastric cancer and to identify factors associated with increased risk of suicide using the Surveillance, Epidemiology, and End Results database.


METHODS
The database was queried for patients who were diagnosed with gastric cancer from 1998 to 2011. The rate of suicide and standardized mortality ratio were calculated. Multivariable analyses were conducted to identify factors associated with increased risk of suicide.


RESULTS
A total of 65 535 patients with 109 597 person-years of follow-up were included. A total of 68 patients died of suicide. The age-adjusted rate of suicide was 34.6 per 100 000 person-years (standardized mortality ratios, 4.07; 95% confidence interval, 3.18-5.13). The rate of suicide was highest within the first 3 months after cancer diagnosis (standardized mortality ratios, 67.67; 95% confidence interval, 40.74-106.15). Results of multivariable analyses showed that male sex (incidence rate ratio, 7.15; 95% confidence interval, 3.05-16.78; P < 0.0001), White race (incidence rate ratio, 3.23; 95% confidence interval, 1.00-10.35; P = 0.0491), unmarried status (incidence rate ratio, 2.01; 95% confidence interval, 1.22-3.30; P = 0.0060) and distant stage disease (incidence rate ratio, 2.90; 95% confidence interval, 1.72-4.92; P < 0.0001) were significantly associated with increased risk of suicide.


CONCLUSIONS
Patients with gastric cancer have an ~4-fold higher risk of suicide compared with the general US population. The suicide risk is highest within the first 3 months after diagnosis. Male sex, White race, unmarried status and distant stage disease are significantly associated with increased risk of suicide.
Department of Radiation Oncology, Tokai University Hachioji Hospital, Hachioji h4411@wave.plala.or.jp.
Akitomo
A
Sugawara
Department of Radiation Oncology, Tokai University School of Medicine, Isehara, Japan.
Etsuo
E
Kunieda
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008393:Marriage; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology; D013405:Suicide / Q000706:statistics & numerical data*; D055815:Young Adult
gastric cancer; incidence; population based; standardized mortality ratio; suicide