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Suicide ideation increased among adult survivors of childhood cancer
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The risk for suicide ideation was linked to cancer diagnosis and mental and physical health posttreatment in adult survivors of childhood cancers and was higher in survivors than in a sibling comparison group.
Researchers compared data from 9,126 survivors of childhood cancers and 2,968 siblings without cancer from the Childhood Cancer Survivor Study.
More survivors (7.8%) than siblings (4.5%) reported suicidal ideation (OR=1.79; 95% CI, 1.4-2.4). The highest prevalence of suicide ideation (10.6%) was noted in survivors of central nervous system cancers; these survivors were also significantly more likely to report suicide ideation than survivors of leukemia (OR=1.5; 95% CI, 1.2-1.9).
Thoughts of suicide were not associated with age at diagnosis, time since diagnosis, type of cancer therapy, recurrence or secondary malignancy, according to the researchers. Among survivors, suicide ideation was not statistically linked to age or sex but was linked to low levels of education, lower household income and lack of recent employment.
Indicators of poor health were associated with higher prevalence of suicide ideation: Survivors reporting poor health status had a prevalence of 28.8% vs. 3.3% for those reporting excellent health. Disabled status (OR=2.7; 95% CI, 2.2-3.3), the number and severity of medical conditions and cancer-related pain (OR=4.5; 95% CI, 3.3-6.0) were associated with suicide ideation as well.
Depression was associated with suicide ideation in both groups. The OR was 20.4 for survivors (95% CI, 17.2-24.3) and 28 for siblings (95% CI, 19.0-41.4). When adjusted for all covariates, CNS cancer diagnosis, earlier age of diagnosis, higher level of depression, poor health ratings and cancer pain remained significantly associated with suicide ideation.
“Direct assessment of hopelessness and suicidal thoughts is recommended in evaluating cancer patients, and these results indicate that similar assessment should be routine for cancer survivors, especially those facing significant health problems or limitations in functioning,” the researchers wrote.
Recklitis CJ. J Clin Oncol. 2009;doi:10.1200/JCO.2009.22.8635.