Department of Pharmacy, Yantai Yuhuangding Hospital, Yantai, China.
Department of Urology, Yantai Yuhuangding Hospital, Yantai, China.
Cancer Med. 2019 Sep;8(11):5386-5396. doi: 10.1002/cam4.2400. Epub 2019 Jul 11.
The suicide risk was higher in kidney cancer patients than in the general population. The purpose of this study was to characterize the suicide rates among kidney cancer patients and to identify the potential risk factors associated with suicide from the Surveillance, Epidemiology, and End Results (SEER) database.
Kidney cancer patients were identified from the SEER database during 1973-2015. Suicide rates and standardized mortality ratios (SMRs) of this population were calculated, and the US general population during 1981-2015 was chosen as a reference. Univariable and multivariable Cox regression were performed to find out potential risk factors of suicide.
There were 207 suicides identified among 171 819 individuals with kidney cancer observed for 948 272 person-years. The suicide rate was 21.83 per 100 000 person-years, and SMR was 1.83 (95% CI: 1.59-2.10). On Cox regression, diagnosis in early years (1973-1982 vs 2003-2015, HR: 2.03, 95% CI: 1.01-4.11, P = 0.048; 1983-1992 vs 2003-2015, HR: 1.99, 95% CI: 1.18-3.35, P = 0.010), male sex (vs female sex, HR: 4.43, 95% CI: 2.95-6.65, P < 0.001), unmarried status (vs married status, HR: 2.54, 95% CI: 1.91-3.38, P < 0.001), non-black race (white race vs black race, HR: 4.47, 95% CI: 2.09-9.58, P < 0.001; other races vs black race, HR: 3.01, 95% CI: 1.08-8.37, P = 0.035), higher histologic grade (grade IV vs grade I, HR: 3.27, 95% CI: 1.50-7.13, P = 0.003; grade III vs grade I, HR: 2.13, 95% CI: 1.19-3.81, P = 0.011) and cancer-directed surgery not performed (vs performed, HR: 2.78, 95% CI: 1.52-5.11, P < 0.001) were independent risk factors of suicide among kidney cancer patients.
Diagnosis in early years, male sex, unmarried status, non-black race, higher histologic grade, and cancer-directed surgery not performed were significantly associated with suicide among kidney cancer patients. In order to prevent suicidal death, clinicians should pay more attention to patients with high-risk factors of suicide.
肾癌患者的自杀风险高于普通人群。本研究的目的是从监测、流行病学和最终结果（SEER）数据库中描述肾癌患者的自杀率，并确定与自杀相关的潜在风险因素。
从 SEER 数据库中确定 1973 年至 2015 年期间的肾癌患者。计算该人群的自杀率和标准化死亡率比（SMR），并选择 1981 年至 2015 年的美国普通人群作为参考。使用单变量和多变量 Cox 回归来确定自杀的潜在风险因素。
在观察了 948272 人年的 171819 名肾癌患者中，共发现了 207 例自杀。自杀率为 21.83/100000 人年，SMR 为 1.83（95%CI：1.59-2.10）。在 Cox 回归中，早期诊断（1973-1982 年与 2003-2015 年，HR：2.03，95%CI：1.01-4.11，P=0.048；1983-1992 年与 2003-2015 年，HR：1.99，95%CI：1.18-3.35，P=0.010）、男性（与女性，HR：4.43，95%CI：2.95-6.65，P<0.001）、未婚状态（与已婚状态，HR：2.54，95%CI：1.91-3.38，P<0.001）、非黑人种族（白人种族与黑人种族，HR：4.47，95%CI：2.09-9.58，P<0.001；其他种族与黑人种族，HR：3.01，95%CI：1.08-8.37，P=0.035）、较高的组织学分级（IV 级与 I 级，HR：3.27，95%CI：1.50-7.13，P=0.003；III 级与 I 级，HR：2.13，95%CI：1.19-3.81，P=0.011）和未行癌症定向手术（与行手术，HR：2.78，95%CI：1.52-5.11，P<0.001）是肾癌患者自杀的独立危险因素。
早期诊断、男性、未婚状态、非黑人种族、较高的组织学分级和未行癌症定向手术与肾癌患者自杀显著相关。为了预防自杀死亡，临床医生应更加关注自杀高风险因素的患者。
