Shen Jian, Zhu Mingjian, Li Sihao, Wang Qiangqiang, Wu Jingjing, Li Yating, Wang Qing, Bian Xiaoyuan, Yang Liya, Jiang Xianwan, Xie Jiaojiao, Lu Yanmeng, Wang Kaiceng, Li Lanjuan
State Key Laboratory for the Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).
Collaborative Innovation Center for the Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang, China (mainland).
Med Sci Monit. 2020 Mar 9;26:e920711. doi: 10.12659/MSM.920711.
BACKGROUND The suicide risk of patients with cancer is higher than the general population. Our research aimed to explore the Surveillance, Epidemiology, and End Results (SEER) database to define incidence and quest risk factors for death of suicide in patients with Kaposi's sarcoma (KS) in the United States (US). MATERIAL AND METHODS We screened KS patients without human immunodeficiency virus status in the SEER database from 1980 to 2016, calculated the standardized mortality ratios of them by comparing the rates with those of the US general population from 1980 to 2016, and identified relevant suicide risk factors by univariable and multivariable logistic regression analyses. RESULTS The suicide rates of KS patients and US general population were 115.31 (110 suicides among 21 405 patients) and 15.1 per 100 000 person-years, respectively, thus the standardized mortality ratio was 7.64 (95% confidence interval [CI], 6.28-9.21). The multivariate analysis showed that black race (versus white race, hazard ratio [HR]: 0.43, 95% CI: 0.21-0.89, P=0.022), advanced age at diagnosis (≥55 years versus 18-44 years, HR: 0.31, 95% CI: 0.14-0.66, P=0.002), and chemotherapy (versus no chemotherapy, HR: 0.60, 95% CI: 0.37-0.96, P=0.032) were protective factors for suicide among KS patients. CONCLUSIONS Clinicians and caregivers can apply our findings to identify KS patients with high suicide risk characteristics (white race, age of 18-44 years, non-chemotherapy) and exert timely interventions during patient diagnosis, treatment, and follow-up to reduce the suicide rate in this population.
癌症患者的自杀风险高于普通人群。我们的研究旨在探索监测、流行病学和最终结果(SEER)数据库,以确定美国卡波西肉瘤(KS)患者自杀死亡的发病率和相关风险因素。材料与方法:我们在SEER数据库中筛选了1980年至2016年期间未感染人类免疫缺陷病毒的KS患者,通过将其发病率与1980年至2016年美国普通人群的发病率进行比较,计算出他们的标准化死亡率,并通过单变量和多变量逻辑回归分析确定相关自杀风险因素。结果:KS患者和美国普通人群的自杀率分别为每10万人年115.31(21405例患者中有110例自杀)和15.1,因此标准化死亡率为7.64(95%置信区间[CI],6.28 - 9.21)。多变量分析显示,黑人种族(与白人种族相比,风险比[HR]:0.43,95%CI:0.21 - 0.89,P = 0.022)、诊断时高龄(≥55岁与18 - 44岁相比,HR:0.31,95%CI:0.14 - 0.66,P = 0.002)以及化疗(与未化疗相比,HR:0.60,95%CI:0.37 - 0.96,P = 0.032)是KS患者自杀的保护因素。结论:临床医生和护理人员可以应用我们的研究结果,识别具有高自杀风险特征(白人种族、18 - 44岁、未化疗)的KS患者,并在患者诊断、治疗和随访期间及时进行干预,以降低该人群的自杀率。