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75 岁及以上癌症患者的自杀风险 - 超过 40 万人的随访。

Risk of suicide in patients with cancer aged 75 years or more - Follow-up of over 400,000 individuals.

机构信息

Polish National Cancer Registry, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.

Polish National Cancer Registry, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.

出版信息

Maturitas. 2023 Sep;175:107785. doi: 10.1016/j.maturitas.2023.107785. Epub 2023 Jun 10.

Abstract

BACKGROUND

It is well established that older patients with cancer have a significantly higher risk of suicide. However, a comprehensive understanding of the risk factors is lacking. In this study, we aimed to identify groups at an increased risk of suicide among patients aged ≥75 years with a previous cancer diagnosis.

MATERIAL AND METHODS

All Polish individuals diagnosed with cancer at the age of ≥75 years between 1 January 2009 and 31 December 2019 were included in this study. Standardized mortality ratios (SMRs) and 95 % confidence intervals (CIs) were calculated.

RESULTS

A total of 410,440 patients (211,730 men and 198,710 women) were included in this study. SMR for both sexes was 1.64 (95 % CI 1.43-1.87). When analyzed by sex, a significantly higher risk was observed only in men (SMR 1.70, 95 % CI 1.47-1.95). Among them, the risk of suicide was observed after the diagnosis of lymphoma (2.83, 1.14-5.82), lung cancer (2.63, 1.70-3.89), kidney cancer (2.16, 1.03-3.96), colorectal cancer (1.96, 1.41-2.65), urinary tract cancer (1.86, 1.22-2.70), and prostate cancer (1.40, 1.07-1.82). The highest risk of suicide in men was observed within 6 months of diagnosis (2.83, 2.11-3.71).

CONCLUSIONS

Men diagnosed with cancer at ≥75 years of age are at a higher risk of suicide than men of the same age in the general population. The observations from this study suggest which are the most vulnerable groups of elderly patients with cancer, and the time at which they should be given special support.

摘要

背景

已有充分证据表明,患有癌症的老年患者自杀风险显著升高。然而,对于相关风险因素,我们的认识仍不够全面。本研究旨在确定年龄≥75 岁、既往确诊过癌症的患者中,自杀风险升高的人群。

材料与方法

本研究纳入了 2009 年 1 月 1 日至 2019 年 12 月 31 日期间,年龄≥75 岁、被诊断患有癌症的所有波兰人。计算标准化死亡率(SMR)和 95%置信区间(CI)。

结果

本研究共纳入 410440 例患者(男性 211730 例,女性 198710 例)。男女两性的 SMR 为 1.64(95%CI 1.43-1.87)。按性别分析时,仅男性的自杀风险显著升高(SMR 1.70,95%CI 1.47-1.95)。其中,在诊断出淋巴瘤(2.83,1.14-5.82)、肺癌(2.63,1.70-3.89)、肾癌(2.16,1.03-3.96)、结直肠癌(1.96,1.41-2.65)、尿路上皮癌(1.86,1.22-2.70)和前列腺癌(1.40,1.07-1.82)后,自杀风险升高。男性的自杀风险最高,发生在诊断后 6 个月内(2.83,2.11-3.71)。

结论

年龄≥75 岁、被诊断患有癌症的男性比同年龄段一般人群中的男性自杀风险更高。本研究结果提示了哪些老年癌症患者是最脆弱的群体,以及他们何时需要得到特别支持。

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