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Liu Q, Qu Z, Dong H, Qi Y, Wu J, Zhang W, Wang X, Wang Z, Fang Y, Wang J. Trends in cancer-related suicide in the United States: a population-based epidemiology study spanning 40 years of data. Transl Psychiatry 2024; 14:213. [PMID: 38802377 PMCID: PMC11130301 DOI: 10.1038/s41398-024-02917-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 03/31/2024] [Accepted: 05/07/2024] [Indexed: 05/29/2024] Open
Abstract
Large cohort studies examining trends in cancer-related suicide are lacking. We analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database, encompassing a total of 4,870,410 patients diagnosed with cancer from 1975 to 2017 in the United States. Joinpoint regression was used to estimate the annual percent change (APC) and average annual percentage change (AAPC) of age-adjusted rates of suicide. In the past 40 years, we revealed a gradual increase in cancer-related suicide rates from 1975 to 1989, followed by a gradual decrease from 1989 to 2013, and a marked decrease from 2013 to 2017. These trends suggested the potential impact of advancements in psychosocial care for patients with cancer in contributing to the observed decrease in suicide rates.
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Affiliation(s)
- Qiang Liu
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Zheng Qu
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Hao Dong
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yihang Qi
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
- Department of Breast Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Juan Wu
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Wenxiang Zhang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xiangyu Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Zhongzhao Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Yi Fang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Jing Wang
- Department of Breast Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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Ernst M, Schwinn T, Hirschmiller J, Cleare S, Robb KA, Brähler E, Zwerenz R, Wiltink J, O'Connor RC, Beutel ME. To what extent are psychological variables considered in the study of risk and protective factors for suicidal thoughts and behaviours in individuals with cancer? A systematic review of 70 years of research. Clin Psychol Rev 2024; 109:102413. [PMID: 38518584 DOI: 10.1016/j.cpr.2024.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/29/2023] [Accepted: 03/08/2024] [Indexed: 03/24/2024]
Abstract
Psychological variables substantially shape the risk of suicidal thoughts and behaviours (STBs). However, it is unclear to what extent they are considered in individuals with cancer. We synthesized the quantitative research landscape concerning psychological risk/protective factors of STBs in the (psycho-) oncological context. This pre-registered review (PROSPERO-ID CRD42022331484) systematically searched the databases PubMed/Medline, CINAHL, PsycInfo, Cochrane Library, and Web of Science (as well as the grey literature and preprints). Risk of bias (RoB) was estimated using the ROBINS-I tool. Of 11,159 retrieved records, 319 studies were eligible for inclusion. Of those, 163 (51.1%) had investigated psychological factors (affective: n = 155; social: n = 65; cognitive: n = 63; personality/individual differences: n = 37; life events: n = 6), in a combined 3,561,741 participants. The most common STBs were suicidal ideation (n = 107) or death wishes (n = 20) rather than behaviour (suicide deaths: n = 26; attempts: n = 14). Most studies had a serious RoB. Thus, a large body of research investigated STBs in cancer patients/survivors, but it rarely aligned with the theoretical or clinical developments in suicide research. We propose a conceptual model of STBs in cancer delineating moderation and mediation effects to advance the integration of the fields, and to inform future research and practice.
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Affiliation(s)
- Mareike Ernst
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria; Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Tamara Schwinn
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Judith Hirschmiller
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Seonaid Cleare
- Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Kathryn A Robb
- Cancer Behaviour Research Group, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, Leipzig, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Kitagawa S, Sobue T, Zha L, Morishima T, Ohno Y, Miyashiro I. Suicide risk among patients with cancer by sex in Japan: A population-based study. J Epidemiol 2024:JE20230280. [PMID: 38462529 PMCID: PMC11464848 DOI: 10.2188/jea.je20230280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND In Japan, few studies have examined suicide risk for five-year relative survival rates for cancer sites. Since five-year relative survival rates differ by sex, we aim to examine suicide risk for patients with cancer separately for men and women. METHODS We estimated the risk of suicide among patients with cancer by sex in Japan compared to the general population, using standardized mortality ratios (SMRs). Patients with cancer diagnosed between January 1, 1985-December 31, 2013 and registered in the Osaka Cancer Registry were followed-up with for up to 10 years. The outcome was suicide death. In addition, cancer sites were classified into three prognosis groups based on five-year relative survival rates: good (> 70%), moderate (40-70%), poor (< 40%). RESULTS Among 623 995 patients with cancer observed for 2 349 432 person-years, 1210 patients died by suicide (867 men and 343 women). The SMRs were almost equal for men (1.66, 95% CI, 1.55-1.77) and women (1.65, 95% CI, 1.48-1.83). SMRs for cancer prognosis groups were 1.01 (95% CI, 0.84-1.22) for men and 1.47 (95% CI, 1.24-1.73) for women in the good group, 1.53 (95% CI, 1.39-1.68) for men and 1.74 (95% CI, 1.47-2.05) for women in the moderate group, and 2.54 (95% CI, 2.27-2.85) for men and 1.87 (95% CI, 1.43-2.46) for women in the poor group. CONCLUSIONS In this population, both sexes had higher suicide risk with poor prognosis, but the difference in SMRs between the good and poor groups was smaller for women than men.
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Affiliation(s)
- Shinichi Kitagawa
- Environmental Medicine and Population Sciences, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Tomotaka Sobue
- Environmental Medicine and Population Sciences, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Ling Zha
- Environmental Medicine and Population Sciences, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | | | - Yuko Ohno
- Division of Health Science, Graduate School of Medicine, Osaka University
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute
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Kim J, Gang M. Identifying the Risk Factors of Suicidal Ideation in Patients With Hematologic Malignancies Using a Multidimensional Approach. West J Nurs Res 2024; 46:81-89. [PMID: 38078450 DOI: 10.1177/01939459231216870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
BACKGROUND Patients with hematologic malignancies have a 3.5-fold higher rate of suicide completion than the noncancer population, and the Hodgkin lymphoma has the highest suicide rate among all cancers. Although the risk factors for suicidal ideation among the cancer population are well-known, the specific risk factors contributing to the high suicide rate among patients with hematologic malignancies are elusive. OBJECTIVE This study aimed to identify the risk factors for suicidal ideation among patients with hematologic malignancies using a multidimensional approach. METHODS This was a cross-sectional, observational study. A total of 163 patients were recruited from the oncology department of a university hospital. We collected data on psychological and physical symptoms, social support, and suicidal ideation using the Memorial Symptom Assessment Scale-Short Form, the Multidimensional Scale of Perceived Social Support, and the Suicidal Ideation Scale. Multiple regression analysis was performed using SPSS (version 26.0) to analyze the clinical data. RESULTS Among the 163 participants, 96 (58.9%) were male, 57 (35%) were diagnosed with acute leukemia, and 97 (59.5%) received chemotherapy. The mean age was 55.26 ± 15.75. Physical symptoms, psychological symptoms, and willingness to use mental health services accounted for 39.5% of suicidal ideation cases. CONCLUSIONS Assessment of psychological conditions at the beginning of diagnosis, provision of appropriate interventions throughout treatment, and follow-up care to relieve psychological symptoms should be initiated in patients with hematologic malignancies to prevent suicide.
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Affiliation(s)
- Junglyun Kim
- College of Nursing, Chungnam National University, Daejeon, South Korea
- College of Nursing, University of Florida, Gainesville, FL, USA
| | - Moonhee Gang
- College of Nursing, Chungnam National University, Daejeon, South Korea
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Christensen M, Chan HY, Chan YY, Cheng KY, Cheung TY, Li TY, Situ JL, Tam PL, Tse CC, Ma H. Suicide ideation in older people: a qualitative review and Meta-aggregation of Asian studies. Front Psychiatry 2023; 14:1169820. [PMID: 37671288 PMCID: PMC10475554 DOI: 10.3389/fpsyt.2023.1169820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/10/2023] [Indexed: 09/07/2023] Open
Abstract
Aims To appraise and synthesize qualitative studies examining older Asian people's experiences of suicidal ideation. Design Qualitative review and meta-aggregation. Data sources Four databases were accessed to retrieve papers published between 1990 and 2022 including the grey literature, hand-searching of reference lists of retrieved papers and key journals. The phenomenon of interest included participants older than 60 years old, must have experienced a form of suicidal ideation and/or an unsuccessful attempt, had actively thought about harming themselves and be of Asian ethnicity. Review methods This review was conducted according to Consolidated Criteria for Reporting Qualitative Research and the Joanna Briggs Institute's System for the Unified Management of the Assessment and Review of Information. Results Of the 289 potential studies, seven papers met the inclusion criteria. Two synthesized findings resulted from this review-The Suffering Situation: A Life without Meaning in Older Age and The Healing Situation: A Life Worth Living. The experiences of older Asian people varied from feelings of loneliness, despair and isolation to wanting to live a fruitful life into old age. Conclusion Suicidal ideation in the older person is a growing concern especially with the rise in suicide in this age group. Rising health care costs and erosion of traditional family values means that the older person views themselves as a burden. However, because of the limited number of qualitative studies from an Asian perspective it is difficult to ascertain the full extent of the issues surrounding suicide in older people.
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Affiliation(s)
- Martin Christensen
- School of Nursing, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
- Interdisciplinary Centre for Qualitative Research, School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Hiu Yin Chan
- School of Nursing, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Yuen Yi Chan
- School of Nursing, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Ka Yee Cheng
- School of Nursing, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Tsz Yan Cheung
- School of Nursing, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Tsz Yan Li
- School of Nursing, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Jia Ling Situ
- School of Nursing, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Po Lam Tam
- School of Nursing, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Cheuk Chi Tse
- School of Nursing, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Haixia Ma
- School of Nursing, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
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Predictive value of the Distress Thermometer score for risk of suicide in patients with cancer. Support Care Cancer 2022; 30:5047-5053. [PMID: 35201384 PMCID: PMC9046327 DOI: 10.1007/s00520-022-06801-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 12/31/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aimed to assess the association between the Distress Thermometer (DT) score and risk of suicide in patients with cancer. In addition, we aimed to determine the best cutoff score to predict patients at risk of suicide. METHODS From 2015 to 2016, we retrospectively collected data on patients with cancer. DT scores were collected, and the association between DT score and risk of suicide (suicide ideation or death ideation) was analyzed. Furthermore, receiver operating characteristic (ROC) analysis was performed to identify the appropriate cutoff score for predicting risk of suicide. RESULTS A total of 260 patients with cancer were included, and suicidal ideation was identified in 33 cases referred for psychological intervention. The DT scores of the patients with suicidal ideation were significantly higher than those of patients without suicidal ideation (6.30±2.11 vs. 4.29±1.72, p<0.05). In addition, the area under the ROC curve for predicting risk for suicide was 0.758. The cutoff DT score of 3 had the highest sensitivity of 1.00 to rule out suicidal ideation, while 9 had the highest specificity of 1.00 to rule in suicidal ideation. Moreover, the appropriate cutoff DT score to predict patients with suicidal ideation was 5, with a sensitivity of 0.52, specificity of .84, positive likelihood ratio of 3.24, and negative likelihood ratio of 0.58. CONCLUSION The DT score may be a helpful clinical tool to evaluate emotional distress and risk of suicide in patients with cancer. Clinically, for DT scores greater than 5 in patients with cancer, the risk of suicide greatly increases. In view of the DT's widespread use internationally by non-mental health clinicians in cancer to guide the need for specialist mental health interventions, its potential utility in also predicting suicide risk is of great interest.
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Rögnvaldsson S, Love TJ, Thorsteinsdottir S, Reed ER, Óskarsson JÞ, Pétursdóttir Í, Sigurðardóttir GÁ, Viðarsson B, Önundarson PT, Agnarsson BA, Sigurðardóttir M, Þorsteinsdóttir I, Ólafsson Í, Þórðardóttir ÁR, Eyþórsson E, Jónsson Á, Björnsson AS, Gunnarsson GÞ, Pálsson R, Indriðason ÓS, Gíslason GK, Ólafsson A, Hákonardóttir GK, Brinkhuis M, Halldórsdóttir SL, Ásgeirsdóttir TL, Steingrímsdóttir H, Danielsen R, Dröfn Wessman I, Kampanis P, Hultcrantz M, Durie BGM, Harding S, Landgren O, Kristinsson SY. Iceland screens, treats, or prevents multiple myeloma (iStopMM): a population-based screening study for monoclonal gammopathy of undetermined significance and randomized controlled trial of follow-up strategies. Blood Cancer J 2021; 11:94. [PMID: 34001889 PMCID: PMC8128921 DOI: 10.1038/s41408-021-00480-w] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/31/2021] [Accepted: 04/13/2021] [Indexed: 02/08/2023] Open
Abstract
Monoclonal gammopathy of undetermined significance (MGUS) precedes multiple myeloma (MM). Population-based screening for MGUS could identify candidates for early treatment in MM. Here we describe the Iceland Screens, Treats, or Prevents Multiple Myeloma study (iStopMM), the first population-based screening study for MGUS including a randomized trial of follow-up strategies. Icelandic residents born before 1976 were offered participation. Blood samples are collected alongside blood sampling in the Icelandic healthcare system. Participants with MGUS are randomized to three study arms. Arm 1 is not contacted, arm 2 follows current guidelines, and arm 3 follows a more intensive strategy. Participants who progress are offered early treatment. Samples are collected longitudinally from arms 2 and 3 for the study biobank. All participants repeatedly answer questionnaires on various exposures and outcomes including quality of life and psychiatric health. National registries on health are cross-linked to all participants. Of the 148,704 individuals in the target population, 80 759 (54.3%) provided informed consent for participation. With a very high participation rate, the data from the iStopMM study will answer important questions on MGUS, including potentials harms and benefits of screening. The study can lead to a paradigm shift in MM therapy towards screening and early therapy.
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Affiliation(s)
| | | | - Sigrun Thorsteinsdottir
- Faculty of Medicine, Univeristy of Iceland, Reykjavík, Iceland
- Dept of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - Elín Ruth Reed
- Faculty of Medicine, Univeristy of Iceland, Reykjavík, Iceland
| | | | | | | | | | - Páll Torfi Önundarson
- Faculty of Medicine, Univeristy of Iceland, Reykjavík, Iceland
- Landspítali University Hospital, Reykjavík, Iceland
| | - Bjarni A Agnarsson
- Faculty of Medicine, Univeristy of Iceland, Reykjavík, Iceland
- Landspítali University Hospital, Reykjavík, Iceland
| | | | | | | | | | | | | | | | - Gunnar Þór Gunnarsson
- Faculty of Medicine, Univeristy of Iceland, Reykjavík, Iceland
- Akureyri Hospital, Akureyri, Iceland
| | - Runólfur Pálsson
- Faculty of Medicine, Univeristy of Iceland, Reykjavík, Iceland
- Landspítali University Hospital, Reykjavík, Iceland
| | - Ólafur Skúli Indriðason
- Faculty of Medicine, Univeristy of Iceland, Reykjavík, Iceland
- Landspítali University Hospital, Reykjavík, Iceland
| | | | - Andri Ólafsson
- Faculty of Medicine, Univeristy of Iceland, Reykjavík, Iceland
| | | | - Manje Brinkhuis
- Faculty of Medicine, Univeristy of Iceland, Reykjavík, Iceland
| | | | | | | | | | | | | | | | - Brian G M Durie
- Cedar-Sinai Samual Oschin Cancer Center, Los Angeles, CA, USA
| | | | - Ola Landgren
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Sigurður Yngvi Kristinsson
- Faculty of Medicine, Univeristy of Iceland, Reykjavík, Iceland.
- Landspítali University Hospital, Reykjavík, Iceland.
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Ma W, Wu W, Fu R, Zheng S, Bai R, Lyu J. Coincident Patterns of Suicide Risk Among Adult Patients with a Primary Solid Tumor: A Large-Scale Population Study. Int J Gen Med 2021; 14:1107-1119. [PMID: 33790640 PMCID: PMC8006911 DOI: 10.2147/ijgm.s300740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background Suicide rate is much higher in cancer patients than in general population. This study examined the suicide risk in survivors of primary solid tumor across 19 cancer sites considering risk coincident patterns based on area-based SES indicators. Methods A retrospective search of the SEER database was conducted. Independent risk factors for suicide were identified using the Cox proportional-hazards model. Exploratory factor analysis and cluster analysis were used to create coincident patterns of SES factors. Results Suicide risk was higher for patients with a primary solid tumor who were older, male, white, unmarried, had no insurance, poorly differentiated, distant metastasis and did not undergo active treatment (especially surgery). The suicide risk was higher for patients living in areas with economic and education disadvantage, high levels of immigration and crowding, and high levels of residential instability. Concomitant presence of high economic and education disadvantage, high immigration and crowding levels and low residential instability, showed the highest risk of suicide. Conclusion In order to mitigate suicidal risk, clinicians should pay more attention to patients who are older, male, white, not married, high levels of cancer severity, not received active treatment (especially surgery), and having no insurance. Identifying coincident patterns of suicide help further screen high suicidal risk patients based on area-based socioeconomic status.
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Affiliation(s)
- Wen Ma
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Wentao Wu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Rong Fu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Shuai Zheng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China
| | - Ruhai Bai
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China.,Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, People's Republic of China
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Akechi T, Okuyama T, Uchida M, Kubota Y, Hasegawa T, Suzuki N, Komatsu H, Kusumoto S, Iida S. Factors associated with suicidal ideation in patients with multiple myeloma. Jpn J Clin Oncol 2020; 50:1475-1478. [DOI: 10.1093/jjco/hyaa143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/13/2020] [Accepted: 08/04/2020] [Indexed: 12/25/2022] Open
Abstract
Abstract
Patients with multiple myeloma are at risk of suicide. The study objective was to investigate the clinical risk factors of suicidal ideation among multiple myeloma patients. Consecutive inpatients with a new primary diagnosis of multiple myeloma were recruited. Patients were asked to complete the Patient Health Questionnaire-9 to measure suicidal ideation and depression. Patient demographic and biomedical characteristics (age, gender, education, marital status, employment, performance status and cancer stage) and pain and depression scores were analyzed as potential factors associated with suicidal ideation. Of the 79 patients, 10 [12.6% (95% confidence interval: 7–22)] had suicidal ideation. The results of a logistic regression analysis showed that being unmarried, less advanced cancer stage and depression were significantly associated with the presence of suicidal ideation. These findings suggest that a non-negligible proportion of patients with multiple myeloma experience suicidal ideation and that several multidimensional factors are significantly associated.
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Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Toru Okuyama
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Megumi Uchida
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Yosuke Kubota
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Takaaki Hasegawa
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Nana Suzuki
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hirokazu Komatsu
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shigeru Kusumoto
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Yang J, Liu Q, Zhao F, Feng X, Kaaya RE, Lyu J. Incidence of and sociological risk factors for suicide death in patients with leukemia: A population-based study. J Int Med Res 2020; 48:300060520922463. [PMID: 32383398 PMCID: PMC7221221 DOI: 10.1177/0300060520922463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Suicide is closely related to sociological factors, but sociological analyses of suicide risk in leukemia are lacking. This study is the first to use the Surveillance, Epidemiology, and End Results Program (SEER) database to analyze sociological risk factors for suicide death in leukemia patients. METHODS A retrospective search of the SEER database was conducted. Logistic regression was used to identify independent risk factors for suicide death. Variables significant in the univariate logistic regression models were subsequently analyzed using multivariate regression. RESULTS The death rate was highest in California (1.73%). Suicide mortality was more common during the 1970s and 1980s, after which it trended downward. Young age at diagnosis (18-34 vs. >64 years: odds ratio [OR] = 1.537, 95% confidence interval [CI] = 1.007-2.347; 35-64 vs. >64 years: OR = 1.610, 95% CI = 1.309-1.979), being male (OR = 1.518, 95% CI = 1.230-1.873), and living where a high proportion of people have at least a bachelor's degree (>50% vs. <20%: OR = 8.115, 95% CI = 5.053-13.034) significantly increased suicide death risk. CONCLUSION Our findings could increase clinician awareness of and appropriate support for leukemia patients at risk of death by suicide.
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Affiliation(s)
- Jin Yang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Qingqing Liu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Fanfan Zhao
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Xiaojie Feng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Rahel Elishilia Kaaya
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
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11
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Lennmyr EB, Karlsson K, Abrahamsson M, Ebrahim F, Lübking A, Höglund M, Juliusson G, Hallböök H. Introducing patient-reported outcome in the acute leukemia quality registries in Sweden. Eur J Haematol 2020; 104:571-580. [PMID: 32080889 DOI: 10.1111/ejh.13399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/14/2020] [Accepted: 02/14/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The use of patient-reported outcome (PRO) measured outside clinical trials is not well defined. We report the first analysis of the prospective PRO study within the Swedish acute myeloid leukemia (AML) and the acute lymphoblastic leukemia (ALL) registries. METHODS PRO was requested 6 months after diagnosis. The EORTC Quality of life Questionnaire Core 30-item, the Patient Health Questionnaire-8 (PHQ-8), and questions from a Swedish National Cancer Questionnaire were used. RESULTS An invitation letter was sent to 398 patients; 255 (64%) responded, 60% web-based, and 40% on paper. The ALL cohort had lower physical, role and social functioning, higher symptom burden, and more financial difficulties compared to the AML cohort. A PHQ-8 score ≥ 10p, which indicates depression, was reported in 18% of the patients; 33% of these patients reported being prescribed antidepressants. The patients' overall experience of care was satisfying, but more psychological and practical support was desired. There was no difference in survival between patients who reported their PRO and those who did not. Follow-up at 2 and 4 years is ongoing. CONCLUSIONS PRO collected in a registry-based setting is feasible, but the selection of time points and questionnaires are delicate in a diverse patient population.
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Affiliation(s)
| | - Karin Karlsson
- Department of Hematology, Oncology and Radiophysics, Skåne University Hospital, Lund, Sweden
| | | | | | - Anna Lübking
- Department of Hematology, Oncology and Radiophysics, Skåne University Hospital, Lund, Sweden
| | - Martin Höglund
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Gunnar Juliusson
- Department of Hematology, Oncology and Radiophysics, Skåne University Hospital, Lund, Sweden
| | - Heléne Hallböök
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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12
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Bulotiene G, Pociute K. Interventions for Reducing Suicide Risk in Cancer Patients: A Literature Review. EUROPES JOURNAL OF PSYCHOLOGY 2019; 15:637-649. [PMID: 33680150 PMCID: PMC7909181 DOI: 10.5964/ejop.v15i3.1741] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 11/20/2018] [Indexed: 01/26/2023]
Abstract
The suicide risk of people diagnosed with cancer is two times higher than the general population. The number of cases of diagnosed cancer is estimated to rise by 70% over the next two decades. Evidence-based prevention strategies are necessary to protect this vulnerable group of individuals. The purpose of this review was to find out the risk factors of suicide and which types of interventions can serve as prevention strategies. Psychosocial interventions, pharmacotherapy and physical activity can play a preventive role in reducing psychosocial and physical risk factors, such as mental disorders, poor social support, poor performance status and pain. Further research is needed to develop effective suicide prevention strategies for cancer patients.
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Affiliation(s)
- Giedre Bulotiene
- Department of Physical Medicine and Rehabilitation, National Cancer Institute, Vilnius, Lithuania
| | - Kamile Pociute
- Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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13
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Klaassen Z, Wallis CJ, Chandrasekar T, Goldberg H, Sayyid RK, Williams SB, Moses KA, Terris MK, Nam RK, Urbach D, Austin PC, Kurdyak P, Kulkarni GS. Cancer diagnosis and risk of suicide after accounting for prediagnosis psychiatric care: A matched‐cohort study of patients with incident solid‐organ malignancies. Cancer 2019; 125:2886-2895. [PMID: 31021430 PMCID: PMC10182898 DOI: 10.1002/cncr.32146] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 03/09/2019] [Accepted: 03/14/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Previous studies have demonstrated an association between a diagnosis of cancer and the risk of suicide; however, they failed to account for psychiatric care before a cancer diagnosis, which may confound this relationship. The objective of this study was to assess the effect of a cancer diagnosis on the risk of suicide, accounting for prediagnosis psychiatric care utilization. METHODS All adult residents of Ontario, Canada who were diagnosed with cancer (1 of prostate, breast, colorectal, melanoma, lung, bladder, endometrial, thyroid, kidney, or oral cancer) between 1997 and 2014 were identified. Noncancer controls were matched 4:1 based on sociodemographics, including a psychiatric utilization gradient (PUG) score (with 0 indicating none; 1, outpatient; 2, emergency department; and 3, hospital admission). A marginal, cause-specific hazard model was used to assess the effect of cancer on the risk of suicidal death. RESULTS Among 676,470 patients with cancer and 2,152,682 matched noncancer controls, there were 8.2 and 11.4 suicides per 1000 person-years of follow-up, respectively. Patients with cancer had an overall higher risk of suicidal death compared with matched patients without cancer (hazard ratio, 1.34; 95% CI, 1.22-1.48). This effect was pronounced in the first 50 months after cancer diagnosis (hazard ratio, 1.60; 95% CI, 1.42-1.81); patients with cancer did not demonstrate an increased risk thereafter. Among individuals with a PUG score 0 or 1, those with cancer were significantly more likely to die of suicide compared with controls. There was no difference in suicide risk between patients with cancer and controls for those who had a PUG score of 2 or 3. CONCLUSIONS A cancer diagnosis is associated with increased risk of death from suicide compared with the general population even after accounting for precancer diagnosis psychiatric care utilization. The specific factors underlying the observed associations remain to be elucidated.
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Affiliation(s)
- Zachary Klaassen
- Department of Surgery, Division of Urology University of Toronto, University Health Network, Princess Margaret Cancer Center Toronto Ontario Canada
- Institute for Health Policy, Management, and Evaluation University of Toronto Toronto Ontario Canada
| | - Christopher J.D. Wallis
- Department of Surgery, Division of Urology University of Toronto, University Health Network, Princess Margaret Cancer Center Toronto Ontario Canada
| | - Thenappan Chandrasekar
- Department of Surgery, Division of Urology University of Toronto, University Health Network, Princess Margaret Cancer Center Toronto Ontario Canada
| | - Hanan Goldberg
- Department of Surgery, Division of Urology University of Toronto, University Health Network, Princess Margaret Cancer Center Toronto Ontario Canada
| | - Rashid K. Sayyid
- Division of Urology Medical College of Georgia‐Augusta University Augusta Georgia
| | - Stephen B. Williams
- Division of Urology The University of Texas Medical Branch at Galveston Galveston Texas
| | - Kelvin A. Moses
- Department of Urological Surgery Vanderbilt University Medical Center Nashville Tennessee
| | - Martha K. Terris
- Division of Urology Medical College of Georgia‐Augusta University Augusta Georgia
| | - Robert K. Nam
- Institute for Health Policy, Management, and Evaluation University of Toronto Toronto Ontario Canada
- Division of Urology Sunnybrook Health Sciences Center Toronto Ontario Canada
- Institute for Clinical Evaluative Sciences Toronto Ontario Canada
| | - David Urbach
- Institute for Health Policy, Management, and Evaluation University of Toronto Toronto Ontario Canada
- Institute for Clinical Evaluative Sciences Toronto Ontario Canada
- Department of Surgery University of Toronto, Women’s College Hospital Toronto Ontario Canada
| | - Peter C. Austin
- Institute for Health Policy, Management, and Evaluation University of Toronto Toronto Ontario Canada
- Institute for Clinical Evaluative Sciences Toronto Ontario Canada
| | - Paul Kurdyak
- Institute for Health Policy, Management, and Evaluation University of Toronto Toronto Ontario Canada
- Institute for Clinical Evaluative Sciences Toronto Ontario Canada
- Institute for Mental Health Policy Research Center for Addiction and Mental Health Toronto Ontario Canada
| | - Girish S. Kulkarni
- Department of Surgery, Division of Urology University of Toronto, University Health Network, Princess Margaret Cancer Center Toronto Ontario Canada
- Institute for Health Policy, Management, and Evaluation University of Toronto Toronto Ontario Canada
- Institute for Clinical Evaluative Sciences Toronto Ontario Canada
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14
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Jin S, Liu Y, Hennessy DA, Sun L, Zang Y, Si M, Zhang J. Physical Illnesses and Medically Serious Suicide Attempts in Rural China. CRISIS 2019; 41:15-23. [PMID: 30888227 DOI: 10.1027/0227-5910/a000597] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background: Physical illness is a strong correlate of suicidal behavior. However, its impact on attempted suicide in rural China is under-studied. Aims: This study was designed to assess the influence of physical illness on risk of suicide attempts and to identify distinguishing characteristics among medically serious suicide attempters with physical illnesses from those without. Method: Participants were medically serious suicide attempters identified through hospital emergency rooms (n = 659) as well as age- and gender-matched community controls (n = 659) from Shandong Province, China. Face-to-face interviews with the respondents were conducted with a semistructured protocol that included sociodemographic and psychological measures. Results: Physical illness was a significant risk factor for medically serious suicide attempts (OR = 1.739, 95% CI = 1.182-2.560). Older age was a significant risk factor, while female gender, no religion, and non-peasant occupations were significant protective factors for suicide attempts with physical illness. Limitations: Samples from only one province may not completely represent all serious suicide attempters in China. Furthermore, we did not assess the severity and the degree to which their physical illness limited the functioning of the individual. Conclusion: Physical illness is an important risk factor for suicide attempts in rural China. More efforts are needed to specifically target older people, males, those with religious beliefs, and peasant workers with physical illness.
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Affiliation(s)
- Shenghua Jin
- Fuzhou University Institute of Psychological and Cognitive Sciences and Center for China Social Trust Research, Fuzhou, Fujian Province, China
| | - Yanzheng Liu
- Shandong University School of Public Health Center for Suicide Prevention Research, Jinan, Shandong Province, China
| | - Dwight A Hennessy
- Department of Psychology, State University of New York Buffalo State, New York, USA
| | - Long Sun
- Shandong University School of Public Health, Jinan, Shandong Province, China
| | - Yuli Zang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, China
| | - Min Si
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, China
| | - Jie Zhang
- Shandong University School of Public Health Center for Suicide Prevention Research, Jinan, Shandong Province, China.,Department of Sociology, State University of New York Buffalo State, New York, USA
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15
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Riordan P, Briscoe J, Kamal AH, Jones CA, Webb JA. Top Ten Tips Palliative Care Clinicians Should Know About Mental Health and Serious Illness. J Palliat Med 2018; 21:1171-1176. [DOI: 10.1089/jpm.2018.0207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Paul Riordan
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina
- Department of Psychiatry, and Duke University School of Medicine, Durham, North Carolina
| | - Joshua Briscoe
- Department of Section of Palliative Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Arif H. Kamal
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina
- Department of Section of Palliative Medicine, Duke University School of Medicine, Durham, North Carolina
- Duke Cancer Institute, Duke University, Durham, North Carolina
- Duke Fuqua School of Business, Duke University, Durham, North Carolina
| | - Christopher A. Jones
- Perelman School of Medicine and Palliative and Advanced Illness Research Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jason A. Webb
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina
- Department of Psychiatry, and Duke University School of Medicine, Durham, North Carolina
- Department of Section of Palliative Medicine, Duke University School of Medicine, Durham, North Carolina
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16
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Klaassen Z, Yaguchi G, Terris MK. How can we decrease suicide risk in cases of genitourinary cancer? Future Oncol 2015; 11:2113-5. [PMID: 26235177 DOI: 10.2217/fon.15.131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Zachary Klaassen
- Department of Surgery, Section of Urology, Medical College of Georgia - Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA
| | - Grace Yaguchi
- Department of Surgery, Section of Urology, Medical College of Georgia - Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA
| | - Martha K Terris
- Department of Surgery, Section of Urology, Medical College of Georgia - Georgia Regents University, 1120 15th Street, Augusta, GA 30912, USA
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