Oberaigner Willi, Sperner-Unterweger Barbara, Fiegl Michael, Geiger-Gritsch Sabine, Haring Christian
Department of Clinical Epidemiology of the Tyrolean State Hospitals Ltd., Cancer Registry of Tyrol, Anichstrasse 35, A-6020 Innsbruck, Austria; Department of Public Health and HTA, UMIT, Hall/Tyrol, Austria.
Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
Gen Hosp Psychiatry. 2014 Sep-Oct;36(5):483-7. doi: 10.1016/j.genhosppsych.2014.05.017. Epub 2014 Jun 2.
To investigate whether suicide risk in Tyrol/Austria was increased for cancer patients as compared to the general population and whether subgroups at excess risk could be defined.
Cohort design based on all malignant cancer cases diagnosed in Tyrol between 1991 and 2010 and excluding nonmelanoma skin cancer. Entry date was date of diagnosis of the index cancer; exit date was either date of suicide or date of death for reasons other than suicide or end of follow-up (Dec 31, 2011). Standardized mortality ratios (SMRs) were computed in the classical way after adjustment for sex, age and year of follow-up.
For all cancer sites except nonmelanoma skin cancer, we observed a SMR of 1.86 [95% confidence interval (CI), 1.57-2.19]. Suicide risk was greatest during the first 6 months after diagnosis with an SMR of 4.74 (95% CI, 3.27-6.66) and was more than fivefold in cases with advanced Stage IV. We observed the greatest excess risk for suicide in patients with head and neck cancers (13 suicides; SMR, 4.73; 95% CI, 2.52-8.09) and lung cancer (14 suicides; SMR, 4.16; 95% CI, 2.27-6.98).
In our study population in Tyrol/Austria, we observed a twofold suicide risk in cancer patients as compared with the general population, with the excess risk concentrated in the period shortly after diagnosis and in patients with poor prognosis. Therefore, psychooncological care should be intensified in this group of patients.
调查奥地利蒂罗尔州癌症患者的自杀风险与普通人群相比是否增加，以及是否可以确定存在额外风险的亚组。
基于1991年至2010年在蒂罗尔州诊断出的所有恶性癌症病例进行队列设计，不包括非黑色素瘤皮肤癌。入组日期为索引癌症的诊断日期；退出日期为自杀日期、因非自杀原因死亡的日期或随访结束日期（2011年12月31日）。在对性别、年龄和随访年份进行调整后，以经典方法计算标准化死亡比率（SMR）。
除非黑色素瘤皮肤癌外的所有癌症部位，我们观察到SMR为1.86[95%置信区间（CI），1.57 - 2.19]。诊断后的前6个月自杀风险最高，SMR为4.74（95% CI，3.27 - 6.66），IV期晚期病例的自杀风险超过五倍。我们观察到头颈部癌症患者（13例自杀；SMR，4.73；95% CI，2.52 - 8.09）和肺癌患者（14例自杀；SMR，4.16；95% CI，2.27 - 6.98）的自杀额外风险最大。
在我们奥地利蒂罗尔州的研究人群中，我们观察到癌症患者的自杀风险是普通人群的两倍，额外风险集中在诊断后不久的时期以及预后较差的患者中。因此，应加强对这组患者的心理肿瘤护理。
