Thyroid Malignancy and Suicide Risk: An Analysis of Epidemiologic and Clinical Factors

Abstract

Aim: To date, there has been no specific examination of suicide rates and factors associated with suicide in thyroid cancer. The aim of this study is to examine suicide incidence and associated factors in thyroid cancer patients from 1973 to 2013. and Control using the Web-based Injury Statistics Query and Reporting System (WISQARS). Standardized mortality ratios (SMRs) and multivariable logistic regression models generated odds ratios (ORs) for the identification of factors associated with suicide. Results:Overall, 154 suicides among 168,339 patients were identified. There was no statistically significant difference in suicide rate with respect to age, marital status, median household income, surgical intervention, stage at diagnosis, or histologic subtype. On multivariable analysis male gender and Caucasian race were associated with increased risk of suicide with ORs of 5.39 and 3.17 respectively. Conclusion:Race and gender appear to influence suicide rates in patients with thyroid cancer. Females and whites were more likely to commit suicide as noted previously. There was no statistically significant relationship between suicide and marital status, income, mode of radiation therapy, and the role of surgical intervention. These results, coupled with further studies and analyses, could be used to formulate a comprehensive suicide risk factor scoring system for screening all cancer patients.Clinical significance: Thyroid cancer is very treatable with excellent long-term survival and outcomes. Improved screening and risk factor stratification in these patients could decrease the incidence of suicide in thyroid cancer patients.

Suicide among Cancer Patients: Current Knowledge and Directions for Observational Research

“…This study also found that in counties with an unemployment rate <5% there was a smaller elevation in suicide risk than in counties with an unemployment rate >5%. By contrast, Walsh, et al found that among thyroid cancer patients, household income had no effect on suicide risk [11].…”

“…Particularly high risks were found for pancreatic cancer (SMR = 6.43, 95% CI: 5.49-7.37) and esophageal cancer (SMR = 5.45, 95% CI: 4.66-6.35) [9,10]. By contrast, no effect was seen for prostate cancer (SMR = 0.95, 95% CI: 0.90-1.00) and a reduction in risk was seen for thyroid cancer (SMR = 0.59, 95% CI: 0.50-0.69) [11,12].…”

Risk factors for suicide in individuals with cancer: an integrative literature review

“…More than a cultural aspect, the poor prognosis of a disease, in addition to the adverse effects of treatment, makes individuals with cancer dependent on another person, such as a family member (19) . Male, white and old age were risk factors for suicide in individuals with cancer, as found in twelve articles (25)(26)(27)(28)(29)(31)(32)(33)(34)(35)(36)(37) . Increased risk of suicide for men due to cancer was related to socioeconomic situations, as men end up moving away from work, reducing family income (19)(20)24) .…”

“…For individuals with cancer who committed suicide, the profile shown in the articles was male, white and older than 60 years (25)(26)(27)(28)(29)(31)(32)(33)(34)(35)(36)(37) . Being single was also associated with increased risk of suicide in seven studies (25)(26)30,32,(34)(35)(36) .…”