Are cancer patients at higher suicide risk than the general population?: A nationwide register study in Sweden from 1965 to 1999
Are cancer patients at higher suicide risk than the general population?: A nationwide register study in Sweden from 1965 to 1999
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DOI：
10.1080/14034940410019226
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发表时间：
2005-06-01
影响因子：
3.4
通讯作者：
Rosén, M
中科院分区：
文献类型：
--
作者：
Björkenstam, C;Edberg, A;Rosén, M
目的：测试自杀在癌症患者中是否比普通人群中更普遍，这种关联是否会随着时间的推移而变化，以及风险是否取决于癌症疾病的严重程度。设计：进行登记研究，按性别、时间段(1965-74年、1975-84年和1985-94年)和五年生存率分析不同癌症部位的标准化自杀率。地点：地点为1965-1999年间的瑞典人口。研究对象：研究队列为1,031,919例癌症病例和2,587,152人年。主要观察指标：以世界人口为标准人口的标准化死亡率(SMR)为主要结果指标。结果：癌症患者比普通人群有更高的自杀风险。在一九六五至七四年间，男性癌症病人与一般人口的自杀率比率约为2.5，其后在一九八五年至九四年下降至约1.5。女性癌症患者的自杀率在1965-74年超过2.9，在1985-94年超过2.3。事实上，一九八五至九四年度的妇女生育率较一九七五至八四年度略高。存活率和自杀率之间也有很强的负相关，即存活率低的严重癌症部位的自杀率更高。结论：我们的发现支持癌症患者比普通人群有更大的自杀风险的假设。癌症的严重性增加了自杀的风险。呼吁更多地关注癌症患者的心理和护理状况。
Objectives: The aims were to test whether suicide is more prevalent among cancer patients than among the general population, whether the association changes over time, and whether the risk depends on the severity of the cancer disease. Design: A register study was carried out, where standardized suicide rates for different cancer sites were analysed by sex, time periods ( 1965 - 74, 1975 - 84, and 1985 - 94), and five-year survival rates. Setting: The setting was the Swedish population from 1965 to 1999. Subjects: The cohort studied was 1,031,919 cancer cases and 2,587,152 person-years. Main outcome measures: The main outcome measure was the standardized mortality ratio (SMR) with the world population as standard population. Results: Cancer patients run a higher risk of suicide than the general population. The suicide rate ratio between male cancer patients and the general population was about 2.5 in 1965 - 74, which thereafter reduced to about 1.5 in 1985 94. The suicide rate among female cancer patients was in excess of 2.9 in 1965 - 74 and 2.3 in 1985 - 94. In fact, a slightly higher rate for women was observed for 1985 - 94 than for 1975 - 84. There is also a strong negative association between survival rates and suicide rates, i.e. suicide rates are higher for severe cancer sites with low survival rates. Conclusions: Our findings support the hypothesis that cancer patients run greater risks of committing suicide than the general population does. The severity of the cancer increases the suicide risk. More attention to cancer patients' psychological and care situation is called for.