Cancer-related suicides decline sharply since 2013
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Key takeaways:
- Cancer-related suicide rates decreased dramatically between 2013 and 2017.
- Advances in psychosocial care may have contributed to this trend, according to researchers.
The rate of cancer-related suicides in the U.S. declined considerably in the past few decades, results of a population-based retrospective study published in Translational Psychiatry showed.
The trend began with a gradual decrease from 1989 through 2013, followed by an approximately 27% annual decline between 2013 and 2017.
Background and methods
Suicide is the 10th leading cause of death in the United States.
The rate of suicide among individuals with cancer traditionally has been higher than that observed in the general population.
Contributing factors may include intense or uncontrolled pain, psychological distress and diminished quality of life.
Improved cancer screening and treatment, as well as increased emphasis on psychosocial support for people with cancer, have prolonged survival and improved quality of life. However, evidence on the impact of these advances on cancer-related suicide trends is limited, according to study background.
Qiang Liu, MD, of the National Cancer Center at the Chinese Academy of Medical Sciences in Beijing, and colleagues used the SEER database to examine age-adjusted rates of cancer-related suicide from 1975 to 2017.
The analysis included more than 4.8 million people (51.2% female and 48.8% male). Researchers determined 8,114 (0.16%) of these people died by suicide, the majority of whom were male (81.7%), white (92.8%), and aged 50 to 79 years (72.5%).
Investigators used regression analysis to estimate the annual percent change (APC) and average annual percentage change (AAPC) in age-adjusted rates of suicide.
Key findings
Results showed a gradual increase in cancer-related suicide rates from 1975 to 1989 (APC, 2.6%; 95% CI, 1.4-3.8), followed by a gradual decline between 1989 and 2013 (APC, – 3.9%; 95% CI, –4.4 to –3.4), and then a sharp decline between 2013 and 2017 (APC, –27.3; 95% CI, –37.2 to –15.8).
Between 2013 and 2017, researchers observed particularly steep declines in cancer-related suicide among men (APC, 20.4%; 95% CI, 27 to 13.1) and white individuals (APC, 25.5%; 95% CI, 35.7 to 13.8). They also reported sharp declines across age groups, including individuals aged 15 to 49 years (APC, 16.8%; 95% CI, 26.3 to 6.2), those aged 60 to 69 years (APC, – 34%; 95% CI, 48.5 to 15.4), and those aged 70 to 79 years (APC, –18.9%; 95% CI, –29 to –7.2).
The cancer-related suicide rate remains approximately double that of the general U.S. population, Liu and colleagues wrote.
“Notably, the risk of suicide in men is significantly higher compared to women,” they wrote. “This heightened cancer-related suicide risk remains elevated for up to 15 years following their diagnosis.”
The researchers acknowledged study limitations. SEER pathology terminology has changed due to advances in tumor classification, making it challenging to accurately compare SEER data between time periods.
“To the best of our knowledge, this is the first study to depict the changing patterns of cancer-related suicide trends and their variations based on the characteristics of patients and to compare them with the general U.S. population,” Liu and colleagues wrote. “[Although] our study does not establish a causal relationship, it suggests that improvements in psychosocial care over the last few decades, along with advancements in cancer treatment and prevention, may have contributed to this downward trend. “It is important to note that despite this decreasing cancer-related trend among patients, overall suicide rates in the general U.S. population have increased.”
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Liu Q, et al. Transl Psychiatry. 2024;doi:10.1038/s41398-024-02917-9.
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