Increased Risk of Suicide among Cancer Survivors Who Developed a Second Malignant Neoplasm
Table 3
Risk of suicide among individuals with a second malignant neoplasm (SMN) diagnosis, by different characteristics, compared with individuals with a first malignant neoplasm (FMN) diagnosis.
No. of suicide cases/no. of accumulated person-years × 10,000 (incidence rate/10,000 person-years)
Hazard ratioa (95% confidence interval)
SMN
FMN
By age at diagnosis (by quantile), y
0.0003
<55
75/315,337.92 (2.38)
2780/15,810,144.58 (1.76)
1.38 (1.09–1.73)
55–65
223/687,006.17 (3.25)
3234/13,794,478.21 (2.34)
1.32 (1.15–1.52)
66–75
339/747,527.17 (4.53)
2816/9,059,181.29 (3.11)
1.33 (1.19–1.50)
>75
300/651,281.67 (4.61)
2100/5,442,154.83 (3.86)
0.96 (0.85–1.09)
By calendar year, y
0.15
1975–1984
68/116,017.71 (5.86)
1584/5,375,711.83 (2.95)
1.43 (1.12–1.82)
1985–1994
191/364,410.29 (5.24)
2296/8,174,559.13 (2.81)
1.40 (1.21–1.63)
1995–2004
260/789,908.79 (3.29)
3473/16,284,736.13 (2.13)
1.21 (1.06–1.37)
2005–2016
418/1,130,816.13 (3.70)
3577/14,270,951.83 (2.51)
1.17 (1.05–1.29)
By sex
0.99
Male
825/1,320,654.54 (6.25)
9030/20,956,633.67 (4.31)
1.20 (1.11–1.29)
Female
112/1,080,498.38 (1.04)
1900/23,149,325.25 (0.82)
1.20 (0.99–1.46)
By race
0.066
White
880/2,091,732.79 (4.21)
10060/36,981,749.92 (2.72)
1.23 (1.15–1.32)
Black
38/181,568.13 (2.09)
368/3,798,398.25 (0.97)
1.70 (1.21–2.41)
By cohabitation status
0.45
Cohabitation
336/746,244.92 (4.50)
4120/13,911,216.5 (2.96)
1.20 (1.07–1.35)
Noncohabitation
546/1,493,855.42 (3.65)
5939/27,156,872.79 (2.19)
1.27 (1.16–1.39)
By tumor size, cm
0.057
<1.5
79/321,027 (2.46)
758/5,869,076.38 (1.29)
1.39 (1.10–1.76)
≥1.5
366/1,025,931.79 (3.57)
3640/16,163,041.38 (2.25)
1.08 (0.97–1.21)
By tumor grade
0.81
Well differentiated
86/306,398.13 (2.81)
1000/5,384,767.58 (1.86)
1.29 (1.03–1.61)
Moderately differentiated
275/769,611.54 (3.57)
3179/14,044,744.63 (2.26)
1.37 (1.21–1.56)
Poorly differentiated/undifferentiated
252/473,608.54 (5.32)
2696/8,978,857.25 (3.00)
1.40 (1.23–1.60)
By chemotherapy/radiotherapy
0.91
No/unknown
630/1,590,770.13 (3.96)
6701/25,942,336.79 (2.58)
1.22 (1.13–1.33)
Yes
307/810,382.79 (3.79)
4229/18,163,622.13 (2.33)
1.23 (1.09–1.38)
By surgery
0.0011
No/unknown
397/662,482.42 (5.99)
4654/10,600,572.79 (4.39)
1.07 (0.96–1.18)
Yes
540/1,738,670.5 (3.11)
6276/33,505,386.13 (1.87)
1.35 (1.23–1.48)
By time interval between FMN and SMN, y
0.84
≤1
246/630,900.92 (3.90)
10930/44,105,958.92 (2.48)
1.24 (1.09–1.40)
2–3
195/464,630.75 (4.20)
10930/44,105,958.92 (2.48)
1.29 (1.12–1.49)
4–6
189/486,033.92 (3.89)
10930/44,105,958.92 (2.48)
1.19 (1.03–1.38)
>6
307/819,587.33 (3.75)
10930/44,105,958.92 (2.48)
1.20 (1.07–1.34)
By follow-up periods, y
0.95
<1
376/509,112.92 (7.39)
3131/6,261,779.63 (5.00)
1.18 (1.06–1.31)
1–2
153/784,901.33 (1.95)
1510/10,511,420.75 (1.44)
1.26 (1.06–1.49)
3–4
199/1,328,072.67 (1.50)
2368/20,421,357.75 (1.16)
1.22 (1.06–1.42)
5–10
143/1,387,784.33 (1.03)
2210/26,923,811.17 (0.82)
1.24 (1.05–1.48)
>10
66/904,527.5 (0.73)
1711/26,133,082.67 (0.65)
1.28 (1.00–1.63)
aCox model was used to estimate hazard ratios (HRs), adjusted for birth year, sex, calendar year, race, cohabitation status, insurance, state, tumor size, grade, chemotherapy/radiotherapy, and surgery.
