Division of Behavioral Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan.
Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Jpn J Clin Oncol. 2021 Apr 30;51(5):744-752. doi: 10.1093/jjco/hyab001.
To conduct the first national population-based study in Japan to characterize risks of death by suicide, other externally caused injuries and cardiovascular diseases within 6 months of cancer diagnosis.
Cancer patients diagnosed between 1 January and 30 June 2016 and registered in the National Cancer Registry in Japan were followed up until death or 6 months after diagnosis. We calculated standardized mortality ratios and excess absolute risks per 10 000 person-years for death by suicide, other externally caused injuries and cardiovascular diseases compared with the Japanese general population.
Of 546 148 patients with cancer (249 116 person-years at risk), we observed 145 suicides, 298 deaths due to other externally caused injuries and 2366 cardiovascular deaths during the follow-up period. Standardized mortality ratios within 6 months were 2.68 for suicide (95% confidence interval, 2.26-3.16; excess absolute risk, 3.65), 1.49 for other externally caused injuries (95% confidence interval, 1.32-1.67; excess absolute risk, 3.92) and 1.38 for cardiovascular diseases (95% confidence interval, 1.33-1.44; excess absolute risk, 26.85). Risks were highest during the first month after cancer diagnosis (standardized mortality ratios: suicide, 4.06 [95% confidence interval, 2.90-5.53]; other externally caused injuries, 2.66 [95% confidence interval, 2.17-3.12] and cardiovascular diseases, 2.34 [95% confidence interval, 2.18-2.51]).
The first 6 months, and especially the first month, after cancer diagnosis were found to be a critical period for risks of death by suicide, other externally caused injuries and cardiovascular diseases. Our findings suggest that oncologists need to evaluate suicidal and cardiovascular risks of patients immediately after cancer diagnosis and provide preventive interventions.
在日本进行首次全国性基于人群的研究，以描述癌症诊断后 6 个月内自杀、其他外部原因导致的伤害和心血管疾病的死亡风险。
2016 年 1 月 1 日至 6 月 30 日期间诊断出的癌症患者，并在日本国家癌症登记处登记，随访至死亡或诊断后 6 个月。我们计算了标准化死亡率比和每 10000 人年的超额绝对风险，以比较自杀、其他外部原因导致的伤害和心血管疾病的死亡风险与日本一般人群相比。
在 546148 例癌症患者（249116 人年风险）中，我们观察到 145 例自杀、298 例其他外部原因导致的死亡和 2366 例心血管死亡。诊断后 6 个月内的标准化死亡率分别为自杀 2.68（95%置信区间，2.26-3.16；超额绝对风险，3.65）、其他外部原因导致的死亡 1.49（95%置信区间，1.32-1.67；超额绝对风险，3.92）和心血管疾病 1.38（95%置信区间，1.33-1.44；超额绝对风险，26.85）。风险在癌症诊断后第一个月最高（标准化死亡率：自杀 4.06（95%置信区间，2.90-5.53）；其他外部原因导致的死亡 2.66（95%置信区间，2.17-3.12）和心血管疾病 2.34（95%置信区间，2.18-2.51））。
癌症诊断后的头 6 个月，特别是第一个月，是自杀、其他外部原因导致的伤害和心血管疾病死亡风险的关键时期。我们的研究结果表明，肿瘤医生需要在癌症诊断后立即评估患者的自杀和心血管风险，并提供预防干预措施。
