Peak window of suicides occurs within the first month of diagnosis: Implications for clinical oncology

Timothy V. Johnson, Steven J. Garlow, Otis W. Brawley, Viraj A. Master

Research output: Contribution to journalArticle

Abstract

Objective: A diagnosis of cancer can provoke painful emotional reactions and possibly suicidal thoughts in a patient. Consequently, cancer patients carry a twofold increased lifetime risk of suicide. This risk is much higher within 1 year of diagnosis. However, it remains largely unknown whether suicide frequency remains constant within the first year. Therefore, we sought to characterize the distribution of suicides in order to potentially identify a clinically important window of peak suicide risk. Methods: We queried the Surveillance, Epidemiology, and End Results (SEER) database for cancer patients 20+ years old with diagnosed with a single malignancy from 1973 to 2005 and known cause of death, including whether a patient committed suicide. Initial frequency analysis was performed to identify the period of maximum suicide risk. One-way ANOVA was performed to assess the relationship between year of diagnosis and suicide completions within 1 month of diagnosis. Results: The cohort consisted of 3 678 868 patients. Of the total cohort, 0.2% (5875 patients) committed suicide, 36% (2111 patients) within 1 year of diagnosis. One in three (701 of the patients) who committed suicide in the first year did so within 1 month of diagnosis. No change in this distribution occurred over time. Conclusions: Cancer patients carry an increased risk of suicide. However, this risk peaks with the month following diagnosis. Clinicians should be aware of this increased risk and include assessments of mood state and suicidality at the time of initial diagnosis of the malignancy and be prepared to provide referral to mental health treatment providers.

Original languageEnglish (US)
Pages (from-to)351-356
Number of pages6
JournalPsycho-Oncology
Volume21
Issue number4
DOIs
StatePublished - Apr 1 2012
Externally publishedYes

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Keywords

  • Neoplasms
  • Oncology
  • Psychiatry
  • SEER program
  • Suicide

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Oncology
  • Psychiatry and Mental health

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