Incidence and risk factors of suicide among patients with pancreatic cancer: A population-based analysis from 2000 to 2018.
Incidence and risk factors of suicide among patients with pancreatic cancer: A population-based analysis from 2000 to 2018.
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DOI：
10.3389/fonc.2022.972908
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发表时间：
2022
影响因子：
4.7
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中科院分区：
文献类型：
--
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胰腺癌患者确诊后一年内自杀率较高，但基于目前大规模数据的自杀研究尚属空白。我们的研究旨在确定与普通人群相比，自杀的标准化死亡率（SMR）和胰腺癌患者自杀的相关风险因素，为预防提供线索。我们从SEER数据库中收集了2000年至2018年期间诊断为胰腺癌的199，604例患者。采用多因素Logistic回归和多因素考克斯回归分析胰腺癌患者自杀结局的独立影响因素。在队列中共观察到180例自杀死亡，总自杀率为88.05/10万人年，SMR为6.43。在多变量分析中，发现男性（HR：12.798，95% CI：7.471-21.923）、未婚（HR：1.826，95% CI：1.205-2.767）和离婚、分居或丧偶（HR：1.779，95% CI：1.230-2.572）与较高的自杀风险相关。而黑人（HR：0.250，95% CI：0.110-0.567），诊断为胰腺神经内分泌肿瘤（HR：0.487，95% CI：0.276-0.859），接受化疗（HR：0.456，95% CI：0.323-0.646），接受手术治疗（HR：0.553，95% CI：0.342-0.895）可能为保护因素。2000年至2018年期间诊断的199，604名胰腺癌患者的总体自杀率为每10万人年88.05人，与美国普通人群相比，SMR为6.43。男性、白色、未婚、胰腺癌患者自杀风险较高，而癌症导向手术和化疗可能是保护因素。对于有不良危险因素的胰腺癌患者，应加强筛查和预防过程。此外，有理由认为，及时的癌症导向治疗可能有助于降低胰腺癌患者随后的自杀风险。
The rate of suicide within one year after diagnosis in pancreatic cancer patients are high, but suicide studies based on the current large-scale data are still a vacancy. Our study aimed to determine, compared to the general population, the standardized mortality ratios (SMRs) of suicide and risk factors associated with pancreatic cancer patients committing suicide to provide clues for prevention. We collected 199,604 patients diagnosed with pancreatic cancer between 2000 and 2018 from the SEER database. Multivariate logistic regression and multivariate Cox regression were applied to determine the risk factors independently affecting the suicide outcome of pancreatic cancer patients. A total of 180 suicide deaths were observed in the cohort, yielding an overall suicide rate of 88.05 per 100,000 person-years and an SMR of 6.43. In multivariate analyses, males (HR: 12.798, 95% CI: 7.471-21.923), unmarried (HR: 1.826, 95% CI: 1.205-2.767), and divorced, separated or widowed (HR: 1.779, 95% CI: 1.230-2.572) were found associated with a higher risk of suicide. While race black (HR: 0.250, 95% CI: 0.110-0.567), diagnosed with pancreatic neuroendocrine tumor (HR: 0.487, 95% CI: 0.276-0.859), received chemotherapy (HR: 0.456, 95% CI: 0.323-0.646), and received surgical procedures (HR: 0.553, 95% CI: 0.342-0.895) were indicated might protective factors. The 199,604 pancreatic cancer patients diagnosed between 2000 and 2018 had an overall suicide rate of 88.05 per 100,000 person-years and an SMR of 6.43 compared to the U.S. general population. Male, white, unmarried, and diagnosed with pancreatic adenocarcinoma patients were associated with a higher risk of suicide, while cancer-directed surgery and chemotherapy might indicate protective factors. The screening and prevention process should be enhanced for pancreatic cancer patients with adverse risk factors. Moreover, it is reasonable to assume that timely cancer-directed treatment might help reduce the subsequent suicide risk of pancreatic cancer patients.
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