Male, Caucasian and Elderly Leukemia Patients at Increased Risk of Suicide, Study Finds
Cancer has long been associated with an increased risk of suicide, but to date, no research has been reported on the specific relationship between leukemia and suicide risk.
In an effort to better understand the situation, corresponding author Jun Lyu, MD, PhD, of the First Affiliated Hospital of Jinan University, China, and colleagues, searched the SEER database for patients with leukemia diagnosed between 1975 and 2017.
Lyu said The American Journal of Managed Care® that the absence of specific therapies, the painful complications of the disease and the consequences of treatment (eg hair loss) may affect the psychological well-being of patients.
“These issues will lead to mental stress and psychological problems in patients, which will take patients to extremes and end their lives,” Lyu said. “Therefore, paying attention to the suicide rate of these particular cancer patients and exploring their risk factors is of great importance in preventing their suicide. “
SEER analysis of investigators yielded 142,386 patients. Of these, the causes of death for 191 patients were listed as “suicide and self-harm”. These figures led to a standardized death rate of 2.16.
Next, investigators performed univariate and multivariate Cox regression analysis to try to isolate factors that appeared to increase suicide risk. The main factors linked to suicide were white versus black (HR, 6.80), male gender (HR, 4.41), and age, with the highest risk being found in patients over 80 years (HR, 2.94) compared to 39-year-old patients. years and under.
“Despite the similar prevalence rates in men and women with leukemia, the much higher suicide rate in men with leukemia may be related to the poor ability of men to resist psychological pressures and their tendency to self-managed violence, ”the authors wrote.
They said the risk associated with age could be due to quality of life factors or poor outlook on life.
In terms of race, their finding that white leukemia patients kill themselves more often than their black counterparts is consistent with other research. Lyu and his colleagues said this “could be linked to differences in the level of knowledge and culture between racial groups, religious beliefs and economic conditions.”
A diagnosis of AML was also a statistically significant risk factor, with an RR of 2.72 compared to patients with lymphoid leukemia. They said it might have to do with the prognosis or the rapid progression of the disease.
One factor that didn’t seem to increase cancer risk was chemotherapy, which Lyu said was a surprise. Chemotherapy is the primary treatment for patients with leukemia, so Lyu and his colleagues expected patients who received treatment to have lower suicide rates. They do not have.
“However, the results of the study showed that there was no difference in the suicide rates between the two groups of patients, those who received chemotherapy and those who did not,” said Lyu said. “Does this also reflect that current chemotherapy is ineffective for most leukemia patients? Of course, this requires more research to come to a conclusion. “
In the meantime, Lyu and her colleagues said providers need to be vigilant in tracking patients who may be at increased risk for suicide. The first step, they concluded, is to give leukemia patients psychological assessments.
“Providing psychological treatment to leukemia patients at risk for depression can help reduce the risk of suicide, as can the application of active treatment, improve their quality of life and strengthen communication between family members.” , they wrote.
Yu H, Cai K, Huang Y, Lyu J. Risk factors associated with suicide in patients with leukemia: surveillance, epidemiology and end results analysis. Cancer Med. Published online October 6, 2020. doi: 10.1002 / cam4.3502