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

Table 2

Risk of suicide among individuals with a second malignant neoplasm (SMN) diagnosis, by different adjustment strategies, compared with individuals with a first malignant neoplasm (FMN) diagnosis.

Model information	No. of suicide cases/no. of accumulated person-years × 10,000 (incidence rate/10,000 person-years)		Hazard ratio (95% confidence interval)
	SMN	FMN
Different adjustment strategies^a
Model 1: adjusted for birth year, sex, and calendar year	937/2,401,152.92 (3.90)	10930/44,105,958.92 (2.48)	1.24 (1.16–1.32)
Model 2: model 1 + sociodemographic factors (i.e., race, cohabitation status, insurance, and state)			1.23 (1.15–1.32)
Model 3: model 2 + tumor characteristics (i.e., tumor size and tumor grade)			1.22 (1.14–1.31)
Model 4 (full model): model 3 + cancer treatment (i.e., chemotherapy/radiotherapy and surgery)			1.23 (1.14–1.31)

^aCox model was used to estimate hazard ratios (HRs), adjusted for covariates listed in the model information column.