Surveillance and Health Services Research, Intramural Research Department, American Cancer Society, Atlanta, GA, USA.
Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
J Natl Cancer Inst. 2021 Sep 4;113(9):1258-1262. doi: 10.1093/jnci/djaa183.
The suicide rate has steadily increased in the United States during the past 2 decades. Cancer patients have elevated suicide risk because of prevalent psychological distress, treatment side effects, and potentially uncontrolled pain. Efforts to promote psychosocial and palliative care may reduce this risk. Using the 1999-2018 Multiple Cause of Death database, we found a decreasing trend of cancer-related suicide during the past 2 decades with an average annual percentage change (AAPC) of age-adjusted suicide rates of -2.8% (95% confidence interval [CI] = -3.5% to -2.1%) in contrast to an increasing trend of overall suicide rate (AAPC = 1.7%, 95% CI = 1.5% to 1.8%). We also observed the largest declines in cancer-related suicide rates among high-risk populations including male, older age, and certain cancer types, suggesting an evolving role of psycho-oncology and palliative and hospice care during this period.
在过去的 20 年中,美国的自杀率稳步上升。癌症患者由于普遍存在的心理困扰、治疗副作用和潜在的无法控制的疼痛,自杀风险增加。努力促进心理社会和姑息治疗可能会降低这种风险。使用 1999-2018 年多病因死亡数据库,我们发现过去 20 年中与癌症相关的自杀呈下降趋势,年龄调整后自杀率的平均年百分比变化(AAPC)为-2.8%(95%置信区间[CI]为-3.5%至-2.1%),而总体自杀率呈上升趋势(AAPC=1.7%,95%CI=1.5%至 1.8%)。我们还观察到,包括男性、年龄较大和某些癌症类型在内的高危人群中与癌症相关的自杀率下降幅度最大,这表明在此期间心理肿瘤学和姑息治疗和临终关怀的作用不断演变。