Suicide risk following a new cancer diagnosis among Veterans in Veterans Health Administration care.
Cancer Med
; 12(3): 3520-3531, 2023 02.
Article
em En
| MEDLINE
| ID: mdl-36029038
ABSTRACT
BACKGROUND:
Cancer diagnoses are associated with an increased risk for suicide. The aim of this study was to evaluate this association among Veterans receiving Veterans Health Administration (VHA) care, a population that has an especially high suicide risk.METHODS:
Among 4,926,373 Veterans with VHA use in 2011 and in 2012 or 2013, and without VHA cancer diagnoses in 2011, we assessed suicide risk following incident cancer diagnoses. Risk time was from initial VHA use in 2012-2013 to 12/31/2018 or death, whichever came first. Cox proportional hazards regression models evaluated associations between new cancer diagnoses and suicide risk, adjusting for age, sex, VHA regional network, and mental health comorbidities. Suicide rates were calculated among Veterans with new cancer diagnoses through 84 months following diagnosis.RESULTS:
A new cancer diagnosis corresponded to a 47% higher suicide risk (Adjusted Hazard Ratio [aHR] = 1.47, 95% CI 1.33-1.63). The cancer subtype associated with the highest suicide risk was esophageal cancer (aHR = 6.01, 95% CI 3.73-9.68), and other significant subtypes included head and neck (aHR = 3.55, 95% CI 2.74-4.62) and lung cancer (aHR = 2.35, 95% CI 1.85-3.00). Cancer stages 3 (aHR = 2.36, 95% CI 1.80-3.11) and 4 (aHR = 3.53, 95% CI 2.81-4.43) at diagnosis were positively associated with suicide risk. Suicide rates were highest within 3 months following diagnosis and remained elevated in the 3-6- and 6-12-month periods following diagnosis.CONCLUSION:
Among Veteran VHA users, suicide risk was elevated following new cancer diagnoses. Risk was particularly high in the first 3 months. Additional screening and suicide prevention efforts may be warranted for VHA Veterans newly diagnosed with cancer.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Suicídio
/
Veteranos
/
Neoplasias
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Cancer Med
Ano de publicação:
2023
Tipo de documento:
Article