Research Article

Increased Risk of Suicide among Cancer Survivors Who Developed a Second Malignant Neoplasm

Table 1

Characteristics of the study cohort.

SMNa(N = 685727)FMNb(N = 7824709)

Follow-up time, mean (SD), y3.50 (4.47)5.64 (6.53)
Follow-up time, median (Q1–Q3), y1.67 (0.42–5.00)3.17 (0.67–8.67)
Birth year, mean (SD), y1,930 (14.70)1,940 (18.50)
Age at diagnosis, mean (SD), y71.00 (11.60)63.60 (15.10)

Age group (by quantile), no. (%), y
 <5558,180 (8.48)1,939,983 (24.79)
 55–66159,108 (23.20)2,300,439 (29.40)
 67–75206,746 (30.15)1,827,392 (23.35)
 >75261,693 (38.16)1,756,895 (22.45)

Calendar year, no. (%)
 1975–198426,808 (3.91)668,993 (8.55)
 1985–199474,360 (10.84)988,075 (12.63)
 1995–2004163,161 (23.79)2,194,895 (28.05)
 2005–2016421,398 (61.45)3,972,746 (50.77)

Sex, no. (%)
 Male404,391 (58.97)4,012,867 (51.28)
 Female281,336 (41.03)3,811,842 (48.72)

Race, no. (%)
 White586,494 (85.53)6,427,454 (82.14)
 Black63,114 (9.20)797,649 (10.19)
 Others/unknown36,119 (5.27)599,606 (7.66)

Cohabitation status, no. (%)
 Cohabitation249,999 (36.46)2,940,863 (37.58)
 Noncohabitation390,221 (56.91)4,351,566 (55.61)
 Unknown45,507 (6.64)532,280 (6.80)

Insurance, no. (%)
 Insured339,146 (49.46)3,037,767 (38.82)
 Uninsured3,822 (0.56)90,885 (1.16)
 Unknown342,759 (49.98)4,696,057 (60.02)

State, no. (%)
 Alaska533 (0.08)7,495 (0.10)
 California216,848 (31.62)2,767,483 (35.37)
 Connecticut63,227 (9.22)603,280 (7.71)
 Georgia56,227 (8.20)733,285 (9.37)
 Hawaii15,738 (2.30)169,385 (2.16)
 Iowa55,057 (8.03)508,535 (6.50)
 Kentucky26,320 (3.84)337,028 (4.31)
 Louisiana23,977 (3.50)320,179 (4.09)
 Michigan73,514 (10.72)676,773 (8.65)
 New Jersey52,786 (7.70)664,090 (8.49)
 New Mexico17,921 (2.61)223,539 (2.86)
 Utah19,001 (2.77)220,849 (2.82)
 Washington64,578 (9.42)592,788 (7.58)

Cancer sites, no. (%)
 Prostate cancer70,992 (10.35)1,186,195 (15.16)
 Breast cancer45,939 (6.70)1,188,792 (15.19)
 Colorectal cancer82,991 (12.10)835,070 (10.67)
 Lung cancer121,001 (17.65)975,192 (12.46)
 Skin (nonmelanoma)4,064 (0.59)28,036 (0.36)
 CNSc cancer6,630 (0.97)113,471 (1.45)
 Severe cancerd40,647 (5.93)388,774 (4.97)
 Other cancers258,521 (37.70)2,526,393 (32.29)

Smoking-related cancers
 No434,306 (63.34)5,814,303 (74.31)
 Yes251,421 (36.66)2,010,406 (25.69)

Alcohol-related cancers
 No648,254 (94.54)7,467,584 (95.44)
 Yes37,473 (5.46)357,125 (4.56)

Tumor size, no. (%), cm
 <1.566,741 (9.73)791,353 (10.11)
 ≥1.5321,740 (46.92)3,310,859 (42.31)
 Unknown297,246 (43.35)3,722,497 (47.57)

Tumor grade, no. (%)
 Well differentiated61,799 (9.01)734,335 (9.38)
 Moderately differentiated170,021 (24.79)2,069,948 (26.45)
 Poorly differentiated/undifferentiated155,702 (22.71)1,900,555 (24.29)
 Unknown298,205 (43.49)3,119,871 (39.87)

Chemotherapy/radiotherapy
 No/unknown429,626 (62.65)4,356,691 (55.68)
 Yes256,101 (37.35)3,468,018 (44.32)

Surgery
 No/unknown319,150 (46.54)3,240,379 (41.41)
 Yes366,577 (53.46)4,584,330 (58.59)

aSecond malignant neoplasm. bFirst malignant neoplasm. cCentral nervous system. dEsophageal, liver, or pancreatic cancer.