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Harashima S, Fujimori M, Akechi T, Matsuda T, Saika K, Hasegawa T, Inoue K, Yoshiuchi K, Miyashiro I, Uchitomi Y, J Matsuoka Y. Death by suicide, other externally caused injuries and cardiovascular diseases within 6 months of cancer diagnosis (J-SUPPORT 1902). Jpn J Clin Oncol 2021; 51:744-752. [PMID: 33529336 DOI: 10.1093/jjco/hyab001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To conduct the first national population-based study in Japan to characterize risks of death by suicide, other externally caused injuries and cardiovascular diseases within 6 months of cancer diagnosis. METHODS Cancer patients diagnosed between 1 January and 30 June 2016 and registered in the National Cancer Registry in Japan were followed up until death or 6 months after diagnosis. We calculated standardized mortality ratios and excess absolute risks per 10 000 person-years for death by suicide, other externally caused injuries and cardiovascular diseases compared with the Japanese general population. RESULTS Of 546 148 patients with cancer (249 116 person-years at risk), we observed 145 suicides, 298 deaths due to other externally caused injuries and 2366 cardiovascular deaths during the follow-up period. Standardized mortality ratios within 6 months were 2.68 for suicide (95% confidence interval, 2.26-3.16; excess absolute risk, 3.65), 1.49 for other externally caused injuries (95% confidence interval, 1.32-1.67; excess absolute risk, 3.92) and 1.38 for cardiovascular diseases (95% confidence interval, 1.33-1.44; excess absolute risk, 26.85). Risks were highest during the first month after cancer diagnosis (standardized mortality ratios: suicide, 4.06 [95% confidence interval, 2.90-5.53]; other externally caused injuries, 2.66 [95% confidence interval, 2.17-3.12] and cardiovascular diseases, 2.34 [95% confidence interval, 2.18-2.51]). CONCLUSIONS The first 6 months, and especially the first month, after cancer diagnosis were found to be a critical period for risks of death by suicide, other externally caused injuries and cardiovascular diseases. Our findings suggest that oncologists need to evaluate suicidal and cardiovascular risks of patients immediately after cancer diagnosis and provide preventive interventions.
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Affiliation(s)
- Saki Harashima
- Division of Behavioral Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan.,Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Maiko Fujimori
- Division of Behavioral Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tomohiro Matsuda
- Center for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center Japan, Tokyo, Japan
| | - Kumiko Saika
- Center for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center Japan, Tokyo, Japan
| | - Takaaki Hasegawa
- Center for Psycho-Oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Keisuke Inoue
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan.,Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Yutaka J Matsuoka
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
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Insurance status and risk of suicide mortality among patients with cancer: a retrospective study based on the SEER database. Public Health 2021; 194:89-95. [PMID: 33866150 DOI: 10.1016/j.puhe.2021.02.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Given that the presence of insurance may affect the risk of suicide mortality in cancer patients, we aimed to examine the association in a population-based study using the Surveillance, Epidemiologic, and End Results (SEER) database. STUDY DESIGN A retrospective analysis of data from the SEER database. METHODS We conducted a retrospective study using the SEER database. Hazard ratios (HRs), adjusted HRs (aHRs), and 95% confidence intervals (95% CIs) of suicide death were calculated using Cox proportional hazard models to evaluate the risk of suicide mortality among the cohorts. RESULTS Multivariable analysis revealed that cancer patients without insurance had an increased risk of suicide death compared with patients with private insurance (aHR, 1.37; 95% CI, 1.01-1.72), whereas no significant result was observed in patients with any Medicaid (aHR, 1.10; 95% CI, 0.93-1.30; P = 0.27). In addition, the stratified analysis indicated that the risk of suicide death in patients in the uninsured and Medicaid groups presented with localized stage of disease (aHR, 1.32; 95% CI, 1.02, 1.69), White (aHR, 1.34; 95% CI, 1.05, 1.71), and American Indian/Alaska Native and Asian/Pacific Islander (aHR, 1.89; 95% CI, 1.08, 3.30) were greater than insured patients. CONCLUSION Overall, our results indicated that insurance status was a statistically significant predictor of suicide death in patients with cancer. Healthcare providers should identify those patients at high risk of suicide and provide appropriate mental health and psychosocial oncology services in time.
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Lee MJ, Huang CW, Lee CP, Kuo TY, Fang YH, Chin-Hung Chen V, Yang YH. Investigation of anxiety and depressive disorders and psychiatric medication use before and after cancer diagnosis. Psychooncology 2021; 30:919-927. [PMID: 33724591 DOI: 10.1002/pon.5672] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/08/2021] [Accepted: 02/23/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Data regarding the prevalence of depression and anxiety among cancer patients, especially before cancer diagnosis, remains scarce. This study investigated the prevalence of these conditions and associated drug use among cancer patients pre- and post-diagnosis. METHODS This population-based cohort study using data from Taiwan's National Health Insurance Research Database recruited patients with a registered cancer diagnosis and matched control between January 1, 2000, and December 31, 2011. We compared the prevalence of anxiety and depressive disorders between cancer patients and non-cancer participants during a 2-year period both pre- and post-diagnosis by Pearson's chi-square test. Psychiatric medication use was also examined for the associated mental condition. RESULTS We examined participants diagnosed with liver (N = 17,154), colorectal (N = 30,391), breast (N = 40,036), gynecological (N = 23,218), and lung (N = 15,671) cancer. Before the cancer diagnosis, the prevalence of depression was higher in non-cancer participants than in gynecological cancer patients (p = 0.018) but anxiety is higher in liver, colorectal, and lung cancer patients when compared to non-cancer participants (p < 0.05). After the cancer diagnosis, the prevalence of anxiety and depression became significantly higher in all enrolled cancer patients than non-cancer participants (p < 0.05). Similar results were observed in psychiatric medication use trends. CONCLUSIONS This study proposed that patients with liver, colorectal, and lung cancer had an increased risk of developing anxiety, which might be a sentinel diagnosis. The participants had a significantly higher level of anxiety and depressive disorder post-diagnosis, which highlights the importance of the care for both mental and physical conditions in cancer management.
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Affiliation(s)
- Min-Jing Lee
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, ROC.,School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chien-Wei Huang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan, ROC.,School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chuan-Pin Lee
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, ROC
| | - Ting-Yu Kuo
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, ROC
| | - Yu-Hung Fang
- Division of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, ROC.,School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yao-Hsu Yang
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, ROC.,Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, ROC
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Du L, Chen HL. More evidence is needed to reduce the risk of suicide in head and neck cancer patients. Br J Oral Maxillofac Surg 2021; 59:969-970. [PMID: 33972139 DOI: 10.1016/j.bjoms.2020.09.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/03/2020] [Indexed: 10/22/2022]
Affiliation(s)
- L Du
- School of Medicine, Nantong University, Nantong, Jiangsu, PR China
| | - H-L Chen
- School of Public Health, Nantong University, Nantong, Jiangsu, PR China.
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Wang Y, Wei D, Chen H, Chen B, Li J, László KD. Death of a Child and Mortality after Cancer: A Nationwide Cohort Study in Sweden. Cancer Epidemiol Biomarkers Prev 2020; 30:150-157. [PMID: 33082204 DOI: 10.1158/1055-9965.epi-20-0842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/27/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The death of a child is a traumatic life event that may influence mortality in patients with cancer. Only a few studies investigated this association and their findings have been mixed. We analyzed whether the death of a child is associated with mortality in patients with cancer. METHODS We conducted a cohort study of 371,673 parents who were diagnosed with cancer in Sweden during 1973 to 2014 by linking several population-based registers. We analyzed the association between the death of a child after the diagnosis of cancer and mortality using Cox proportional hazards models with time-varying exposure. RESULTS The death of a child was associated with an increased risk of mortality [HR, 1.27; 95% confidence intervals (CI), 1.17-1.39]. The association was present not only in case of children's death due to cancer or other natural deaths, but also in case of unnatural deaths. Mortality was increased only in the long-term follow-up period (HR, 1.42; 95% CI, 1.29-1.56), but not in the short-term (HR, 0.95; 95% CI, 0.78-1.15). The association was most pronounced following loss of an adult child and for patients with reproductive cancers. CONCLUSIONS Death of a child is associated with increased risks of overall and long-term mortality in patients with cancer. The findings that the association was present not only in case of natural but also in case of unnatural deaths suggests that stress-related mechanisms may also operate. IMPACT Our findings highlight the importance of psychosocial support for patients with cancer experiencing severe stress.
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Affiliation(s)
- Yujie Wang
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. .,Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nangjing, China
| | - Dang Wei
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Hua Chen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Baoan Chen
- Department of Hematology and Oncology, Zhongda Hospital, School of Medicine, Southeast University, Nangjing, China
| | - Jiong Li
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Krisztina D László
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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