Suicide and Accidental Death Among Women With Primary Ovarian Cancer: A Population-Based Study

Abstract

BackgroundWomen with ovarian cancer had the highest suicidal rate among all patients with gynecological malignancies, but no large studies about suicide and accidental death for women with ovarian cancers in detail were conducted. We aimed to determine the relative risk of suicide and accidental death among patients with ovarian cancer to that of the general population, and to identify risk factors associated with suicide and accidental death.MethodsData are from the SEER (surveillance, epidemiology, and end results) cancer registry of women diagnosed with ovarian cancer data from 18 registries for the years 1973–2016. The study population comprised 149,204 patients after inclusion and exclusion criteria were applied. Standardized mortality ratios (SMRs) were calculated and Fine-Gray models were fitted to identify risk factors associated with suicidal and accidental death among cancer patients, with stratifications on demographic and tumor-related characteristics.ResultsWomen with ovarian cancer had a higher risk of suicide and accidental death than the cancer-free group [SMR = 1.86; 95% CI (1.54–2.25) and SMR = 1.54; 95% CI (1.39–1.71)]. Subgroup analysis indicated that only patients with type II epithelial ovarian cancer [SMR = 2.31; 95% CI (1.83–2.91)] had an increased risk of suicide, and those with type I and type II epithelial ovarian cancer [SMR = 1.65; 95% CI (1.39–1.97) and SMR = 1.49; 95% CI (1.30–1.70)] were at a higher risk of accidental death. Patients with ovarian cancer who were younger, white, diagnosed with high-grade, non-metastatic cancer and pelvic exenteration were at a higher risk of suicide. The advanced age, earlier year of diagnosis, and non-metastatic cancer were associated with a higher risk of accidental death. Additionally, pelvic exenteration increased the risk of suicide but not the risk of accidental death among women with primary ovarian cancer.ConclusionsWomen with ovarian cancer had a higher risk of suicide and accidental death compared with the general population. The findings suggested that clinicians should identify high-risk subgroups of ovarian cancer patients for suicide and accidental death as early as possible, with appropriate prevention strategies.

Fatal heart disease in patients with bone and soft tissue sarcoma

“…The observed number of HD deaths represented the total number of deaths from heart events in sarcoma patients during the follow-up period; the expected number of deaths represented the number of deaths from heart events in the general population with a similar age at diagnosis, sex, race, and calendar year distribution. Five-year age categories and three-year calendar categories were used for standardization ( 21 ). Mortality from fatal HD was calculated as the number of deaths from HD divided by person-years at risk ( 20 ).…”

Symptom distress and suicidal ideation among Chinese ovarian cancer patients: A moderated mediation model of depression and suicide resilience

“…These include sexual dysfunction ( Rizzuto et al, 2021 ), fertility loss ( Carter et al, 2013 ), menopausal syndrome ( Gernier et al, 2021 ), body image disorders ( Brederecke et al, 2021 ), etc. The high malignancy and adverse outcomes of ovarian cancer may place patients at high suicide risk ( Chen et al, 2022 ). A study based on the SEER database reported a suicide rate of 13.92 per 100,000 person-years between 1973 and 2017, with a relative risk of 1.9 for women with ovarian cancer compared with the general population ( Chen et al, 2022 ).…”

“…The high malignancy and adverse outcomes of ovarian cancer may place patients at high suicide risk ( Chen et al, 2022 ). A study based on the SEER database reported a suicide rate of 13.92 per 100,000 person-years between 1973 and 2017, with a relative risk of 1.9 for women with ovarian cancer compared with the general population ( Chen et al, 2022 ). Extensive literatures have confirmed that the suicide risk of ovarian cancer is highest in patients with gynecological malignancies ( Mahdi et al, 2011 ; Tang et al, 2016 ; Violette et al, 2019 ; Chen et al, 2022 ).…”

“…A study based on the SEER database reported a suicide rate of 13.92 per 100,000 person-years between 1973 and 2017, with a relative risk of 1.9 for women with ovarian cancer compared with the general population ( Chen et al, 2022 ). Extensive literatures have confirmed that the suicide risk of ovarian cancer is highest in patients with gynecological malignancies ( Mahdi et al, 2011 ; Tang et al, 2016 ; Violette et al, 2019 ; Chen et al, 2022 ). A sample based on the Chinese population demonstrated that ovarian cancer patients had suicidal ideation as high as 30.16% ( Tang et al, 2016 ) and remained at the highest risk of suicide over time ( Violette et al, 2019 ; Chen et al, 2022 ).…”

“…Extensive literatures have confirmed that the suicide risk of ovarian cancer is highest in patients with gynecological malignancies ( Mahdi et al, 2011 ; Tang et al, 2016 ; Violette et al, 2019 ; Chen et al, 2022 ). A sample based on the Chinese population demonstrated that ovarian cancer patients had suicidal ideation as high as 30.16% ( Tang et al, 2016 ) and remained at the highest risk of suicide over time ( Violette et al, 2019 ; Chen et al, 2022 ). Therefore, the suicide of ovarian cancer patients deserves attention.…”