Cancer Patients Have 20% Increased Risk of Suicide

Nicky Broyd

June 21, 2018

A conference on cancer data and outcomes has heard how people diagnosed with cancer in England have a 20% higher suicide risk than those in the general population.

Study findings were presented to the Public Health England Cancer Services, Data and Outcomes Conference in Manchester.

A link between a cancer diagnosis and suicide is not new but the research presented is the first to investigate data at a population level in England.

The highest risk was identified to be in the first 6 months following a diagnosis and health professionals are being urged to play a role in offering emotional support to those newly diagnosed with cancer.
 

Cancer and Suicide Data

Using data from the National Cancer Registration and Analysis Service (NCRAS), 4,453,547 people aged 18 to 99 years old at the time of diagnosis were identified in the period covering 1995 to 2015.

Patients were followed until the end of August 2017 with death by suicide and open verdicts recorded.

The study found that 2,352 cancer patients died by suicide - 0.08% of all deaths.

The overall standardised mortality ratios (SMR) for suicide was 1.19 (95% CI 1.14 – 1.24) and absolute excess risks (AER) per 10,000 person-years was 0.18 (0.13 - 0.22).

Patients diagnosed with cancers with the worst outcomes were found to have the highest suicide risk, including:

Conclusions

The study authors from PHE and University College London, led by Katherine Henson, PhD, a senior analyst in PHE's National Cancer Registration and Analysis Service, write that although the suicide numbers were low overall, "the elevated risk of suicide in patients with certain cancers is a concern, representing potentially preventable deaths." 

They say the increased risk in the months after diagnosis, "highlights unmet needs for psychological support delivered alongside cancer diagnosis and treatment. Our findings suggest a need for improved risk stratification across cancer services, followed by targeted psychological support."
 

'Struggling With Their Diagnosis'

In a news release, PHE said the study suggests many cancer patients are struggling with their diagnosis.

It suggests that targeted psychological screening could be integrated into cancer care at an early stage, and that health professionals should consider the risk of suicide "to help avoid potentially preventable deaths".

It said the reasons for suicide linked to cancer "are complex and not fully understood, but may include fear of pain or treatment side-effects".

Dr Jem Rashbass, PHE's cancer lead, said: "Health professionals play a vital role in offering emotional support to cancer patients at this most difficult time. It is important that they recognise the signs of depression, especially when their patients may often have many other physical needs."

Andrew Kaye, Macmillan Cancer Support's head of policy, said: "Being told you have cancer is like being plunged into the unknown and can be an incredibly difficult and frightening time. That's why it's so important that people are given the right support to find their best way through from the moment they're diagnosed.

"Empowering people with cancer to have difficult conversations about how they are feeling and providing vital support are critical to avoiding potentially preventable deaths. Mental health should be taken just as seriously as physical health when looking at a patient's holistic needs."

Risk of suicide after a cancer diagnosis in England: a population-based study, Katherine Henson - Public Health England et al. PHE/NHS England Cancer Services, Data and Outcomes Conference 2018, 20-21 June, Manchester. Abstract.

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