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[癌症登记处登记的癌症患者自杀风险]

[The risk of suicide in cancer patients derived from a cancer registry].

作者信息

Chatton-Reith J, el May H, Raymond L

机构信息

Institut de Médecine Sociale et Préventive, Genève.

出版信息

Rev Epidemiol Sante Publique. 1990;38(2):125-31.

PMID:2374843
Abstract

The incidence of suicide among cancer patients has been examined in several previous epidemiological studies, which have suggested an increased risk especially in the period following diagnosis. The role of factors which may modulate the risk, such as individual patient characteristics or that of cancer (site, prognosis or type of treatment), have not been systematically studied and available results are often contradictory. In Geneva, the existence of a tumor registry, which follows patients continuously until the cause of death is known, has enabled us to conduct a cohort study on all incident cases of cancer registered for the years 1970 to 1983. The risk of suicide (SMR) was found to be significantly elevated for both sexes in the first two years following diagnosis. Thereafter, the risk diminished, and for the entire 15 year period considered, the risk remained significantly elevated only for women. The effect of variables which may have modulated the risk was examined through a logistic regression analysis comparing cases and controls selected from the same cohort. The risk was significantly lower for married patients. No difference between sex was observed, but the risk of suicide appeared to be increased in the elderly, as well as in foreigners, and to be reduced in upper socio-economic classes. Risk could be higher with neoplasms of the digestive tract and lower with those of the breast. Because incidence of suicide is relatively low, studies may lack statistical power to detect a moderately increased risk. Nonetheless, these results confirm part of previous results and contribute further to the study of this problem.

摘要

此前已有多项流行病学研究对癌症患者的自杀发生率进行了调查,这些研究表明自杀风险有所增加,尤其是在确诊后的一段时间内。对于可能调节自杀风险的因素,如个体患者特征或癌症相关因素(部位、预后或治疗类型)的作用,尚未进行系统研究,现有结果往往相互矛盾。在日内瓦,由于存在肿瘤登记处,可对患者进行持续跟踪直至知晓死亡原因,这使我们能够对1970年至1983年登记的所有新发癌症病例开展队列研究。结果发现,在确诊后的头两年,男女自杀风险(标准化死亡比)均显著升高。此后,风险降低,在整个15年的研究期内,仅女性的自杀风险仍显著升高。通过对同一队列中选取的病例和对照进行逻辑回归分析,研究了可能调节自杀风险的变量的影响。已婚患者的自杀风险显著较低。未观察到性别差异,但老年人和外国人的自杀风险似乎有所增加,而社会经济地位较高阶层的自杀风险则有所降低。消化道肿瘤患者的自杀风险可能较高,而乳腺癌患者的自杀风险则较低。由于自杀发生率相对较低,研究可能缺乏检测适度增加风险的统计效力。尽管如此,这些结果证实了先前部分研究结果,并为该问题的研究进一步做出了贡献。

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