Suicide risk in cancer patients from 1960 to 1999
Suicide risk in cancer patients from 1960 to 1999
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DOI：
10.1200/jco.2004.02.052
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发表时间：
2004-10-15
影响因子：
45.3
通讯作者：
Ekeberg, O
中科院分区：
文献类型：
--
作者：
Hem, E;Loge, JH;Ekeberg, O
目的据报道，癌症患者的自杀风险高于一般人群，但估计各不相同，对趋势的分析也很少。本研究的目的是确定癌症患者在1960年至1999年间是否有更高的自杀风险。患者和方法1960年至1997年挪威癌症登记处的一组患者与挪威统计局死亡登记册中的自杀诊断相关联，并在1960年至1999年期间进行观察。该队列包括1960年至1997年在挪威癌症登记处登记的所有癌症患者（N = 490,245例患者，520,823例癌症诊断）。自杀是根据国际疾病分类（第7、8、9和10版）的死亡证明来定义的。结果研究期间共有589例癌症患者自杀，其中男性407例，女性182例。男性和女性的相对危险度升高，标准化死亡率（SMRs）分别为1.55 （95% Cl, 1.41 ~ 1.71）和1.35 （95% Cl, 1.17 ~ 1.56）。在确诊后的头几个月风险最高。在过去的几十年里，男性和女性的相对自杀风险都显著下降。男性呼吸器官癌患者的风险明显增加（SMR, 4.08; 95% Cl, 2.96 ~ 5.47）。除此之外，不同癌症类型的smr从0.76到3.67不等。结论癌症可能是自杀的危险因素，尤其是在确诊后不久。然而，在1960年至1999年期间，相对风险逐渐下降。(C) 2004年由美国临床肿瘤学会出版。
Purpose Suicide risk is reportedly higher for cancer patients than for the general population, but estimates vary and analyses of trends are few. The aim of the present study was to determine whether cancer patients had a higher suicide risk between 1960 and 1999.Patients and Methods A cohort comprising patients from the Cancer Registry of Norway 1960 to 1997 was linked to suicide diagnosis in the Register of Deaths at Statistics Norway and observed during 1960 to 1999. The cohort consisted of all cancer patients registered in the Cancer Registry of Norway 1960 to 1997 (N = 490,245 patients with 520,823 cancer diagnoses). Suicide was defined according to death certificates based on the International Classification of Diseases (versions 7, 8, 9, and 10).Results During the period, 589 cancer patients (407 males and 182 females) committed suicide. The relative risk was elevated for males and females, with standardized mortality ratios (SMRs) of 1.55 (95% Cl, 1.41 to 1.71) and 1.35 (95% Cl, 1.17 to 1.56), respectively. Risk was highest in the first months after diagnosis. For both sexes, there was a significant decrease in the relative suicide risk over decades. The risk was markedly increased among male patients with cancer of respiratory organs (SMR, 4.08; 95% Cl, 2.96 to 5.47). Otherwise, the SMRs varied from 0.76 to 3.67 across cancer types.Conclusion Cancer may be a risk factor for suicide, particularly shortly after diagnosis. However, the relative risk gradually decreased during the period 1960 to 1999. (C) 2004 by American Society of Clinical Oncology.