Suicide Risk among Incident Cases of Cancer in the Swiss Canton of Vaud

Abstract

Data collected by the Cancer Registry of the Canton of Vaud, Switzerland, were used to estimate the risk of suicide for patients diagnosed with cancer. Among 24,166 cases of invasive neoplasms other than nonmelanomatous skin cancer reported between 1976 and 1987 and followed through integrated active follow-up to the end of 1987, for a total of 57,164 person years at risk, there were 55 registered suicides vs. 21.3 expected (standardized mortality ratio, SMR = 2.6; 95% confidence interval, CI = 2.0–3.4). The ratio was slightly, but not significantly higher for males (SMR = 2.8) than for females (SMR = 2.2) and comparable across subsequent age groups. The risk of suicide was high during the 1st year after notification (SMR = 3.9) and decreased to 2.2 between 1 and 5 years and to 1.5 over 5 years. This study suggests that the risk of suicide after a diagnosis of cancer may be greater than previously estimated from cancer registry data in Finland, Sweden, and Connecticut (USA), at least in this population of Central Europe with high overall suicide rates.

High suicide mortality soon after diagnosis among cancer patients in central Italy

“…The risk was elevated in both genders and across subsequent age groups. These results are consistent with the main results of other population-based studies carried out in Connecticut (Campbell, 1996;Fox et al, 1982), Scandinavia (Louhivuori and Hakama, 1979;Olafsen, 1981;Storm et al, 1992;Louhivuori, 1993), Switzerland (Chatton-Reith, 1990; Levi et al, 1991) and Japan (Tanaka et al, 1996).…”

“…During the first year after diagnosis the risk varied from two to five times the expected (Allebeck et al, 1989;Allebeck and Bolund, 1991;Levi et al, 1991;Storm et al, 1992;Tanaka et al, 1996), but among Swedish cancer patients it was considerably higher (SMR = 16.0 for men and SMR = 15.4 for women) (Allebeck et al, 1989).…”

“…Forty-one suicides were observed (SMR = 2.36) which were only 0.2% of all deaths. However, the highest risk (SMR = 27.7) during the first 6 months after diagnosis, represents a greater contrast with the general population than has been observed in other studies.Keywords: suicide; mortality An increased suicide risk has been shown for cancer patients in some population-based studies (Campbell, 1966;Louhivuori and Hakama, 1979;Olafsen, 1981;Fox et al, 1982;Allebeck et al, 1989;Chatton-Reith et al, 1990;Allebeck and Bolund, 1991;Levi et al, 1991; Storm et al, 1992;Louhivuori, 1993;Tanaka et al, 1996). All these studies have been carried out in countries with suicide rates in the general population that are from two to five times greater than in Italy (La Vecchia et al, 1994).…”

“…Some of these studies evidenced a high risk near the time of cancer diagnosis (Fox et al, 1982;Allebeck and Bolund, 1991;Chatton-Reith et al, 1990;Levi et al, 1991;Storm et al, 1992; Tanaka et al, 1996). During the first year after diagnosis the risk varied from two to five times the expected (Allebeck et al, 1989;Allebeck and Bolund, 1991;Levi et al, 1991;Storm et al, 1992;Tanaka et al, 1996), but among Swedish cancer patients it was considerably higher (SMR = 16.0 for men and SMR = 15.4 for women) (Allebeck et al, 1989).…”

Cigarettes and suicide: a prospective study of 50,000 men

“…4,7,67 Consistent with previous studies, [37][38][39] our results indicate that patients with cancer are at risk for taking their own lives. One route from smoking to suicide could be through the development of smoking-related malignant disease.…”