Increased Risk of Suicide among Cancer Survivors Who Developed a Second Malignant Neoplasm
Table 4
Risk of suicide among individuals with a second malignant neoplasm (SMN) diagnosis, by characteristics of the first malignancy, 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 FMN tumor size, cm
0.57
<1.5
62/260,141.08 (2.38)
758/5,869,076.38 (1.29)
1.55 (0.77–3.12)
≥1.5
285/839,718.17 (3.39)
3,640/16,163,041.38 (2.25)
1.26 (1.06–1.50)
By FMN grade
0.54
Well differentiated
118/318,247.38 (3.71)
1,000/5,384,767.58 (1.86)
1.39 (0.82–2.36)
Moderately differentiated
334/817,983.33 (4.08)
3,179/14,044,744.63 (2.26)
1.65 (1.37–1.99)
Poorly differentiated/undifferentiated
212/466,502.54 (4.54)
2,696/8,978,857.25 (3.00)
1.86 (1.47–2.37)
By FMN chemotherapy/radiotherapy
0.013
No/unknown
590/1,525,397.25 (3.87)
6,701/25,942,336.79 (2.58)
1.28 (1.16–1.41)
Yes
347/875,755.67 (3.96)
4,229/18,163,622.13 (2.33)
1.64 (1.39–1.95)
By FMN surgery
0.045
No/unknown
272/512,397.08 (5.31)
4,654/10,600,572.79 (4.39)
1.18 (0.99–1.40)
Yes
665/1,888,755.83 (3.52)
6,276/33,505,386.13 (1.87)
1.45 (1.31–1.61)
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.
