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Suicide and accidental deaths among patients with non‐metastatic prostate cancer
Author(s) -
Dalela Deepansh,
Krishndita,
Okwara James,
Preston Mark A.,
Abdollah Firas,
Choueiri Toni K.,
Reznor Gally,
Sammon Jesse D.,
Schmid Marianne,
Kibel Adam S.,
Nguyen Paul L.,
Me Mani,
Trinh QuocDien
Publication year - 2016
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13257
Subject(s) - medicine , prostate cancer , poisson regression , relative risk , cancer , accidental , confidence interval , hazard ratio , epidemiology , oncology , population , environmental health , physics , acoustics
Objective To determine if American men with prostate cancer are at increased risk of suicide/accidental death compared with other cancers and if the receipt of definitive treatment alters this association, as patients with cancer are at increased risk of suicide and evidence suggests a relationship between suicides and deaths due to accidents and externally caused injuries. Patients and Methods Demographic, socio‐economic and tumour characteristics of men with prostate cancer and men with other solid malignancies were extracted from the Surveillance, Epidemiology and End Results ( SEER ) database (1988–2010). Poisson regression models were fitted to compare the incidence of suicidal and accidental deaths in prostate cancer vs other solid cancers. Multivariate Cox regression was used to determine if receipt of definitive primary treatment impacted the risk of suicide or accidental death in men with localised/regional prostate cancer. Results Risk of suicidal and accidental death was significantly lower in men with prostate cancer (1 165 [0.2%] and 3 199 [0.6%]) than men with other cancers (2 232 [0.2%] and 4 501 [0.5%], respectively), except within the first year of diagnosis (adjusted relative risk [ ARR ] 3.98, 95% confidence interval [ CI ] 3.02–5.23 and ARR 4.22, 95% CI 3.24–5.51, respectively, 0–3 months after diagnosis). Men with non‐metastatic prostate cancer who were White, uninsured, or recommended but did not receive treatment (hazard ratio vs treated 1.44, 95% CI 1.20–1.72, and 1.44, 95% CI 1.30–1.59, both P < 0.001) were at increased risk of suicidal and accidental mortality, respectively. Absence of data about previous co‐morbidities and drug addictions in the SEER dataset was an important limitation. Conclusions Relative to other cancers, men with prostate cancer were at increased risk of suicide and accidental deaths within the first year of diagnosis and when definitive treatment was recommended but not received, suggesting the need for close monitoring and coordination with mental health professionals in at‐risk men with potentially curable disease.