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

2022 ◽  
Vol 2022 ◽  
pp. 1-11
Author(s):  
Huazhen Yang ◽  
Yuanyuan Qu ◽  
Yanan Shang ◽  
Chengshi Wang ◽  
Junren Wang ◽  
...  

Background. Cancer diagnosis entails substantial psychological distress and is associated with dramatically increased risks of suicidal behaviors. However, little is known about the suicide risk among cancer survivors who developed a second malignant neoplasm (SMN). Methods. Using the Surveillance, Epidemiology, and End Results database, we conducted a population-based cohort study involving 7,824,709 patients with first malignant neoplasm (FMN). We measured the hazard ratios (HRs) of suicide death after receiving a SMN diagnosis using Cox proportional hazard models, as compared with patients with FMN. The comparison with the US population was achieved by calculating standardized mortality ratios (SMRs). Results. Totally 685,727 FMN patients received a diagnosis of SMN during follow-up, and we in total identified 10,930 and 937 suicide deaths among FMN and SMN patients, respectively. The HR of suicide deaths was 1.23 (95% confidence interval (CI), 1.14–1.31) after a SMN diagnosis, compared with FMN patients, after adjusting for sociodemographic factors, tumor characteristics, and cancer treatment. As compared with the general population, while both SMN and FMN patients suffered an increased risk of suicide deaths, the excess risk was higher among SMN patients than FMN patients (age-, sex-, and calendar-year-adjusted SMR 1.65 (95% CI 1.54–1.75) vs. 1.29 (95% CI 1.26–1.31); P difference < 0.0001 ). Notably, across different time periods, we observed the greatest risk elevation during the first 3 months after a cancer diagnosis. Conclusions. Compared with either patients with FMN or the general population, cancer survivors who received a SMN diagnosis were at increased risk of suicide death. The risk elevation was most prominent soon after the cancer diagnosis, highlighting the necessity of providing timely psychological support to cancer survivors with a SMN.

2017 ◽  
Vol 77 (4) ◽  
pp. 510-514 ◽  
Author(s):  
Lene Dreyer ◽  
René L Cordtz ◽  
Inger Marie J Hansen ◽  
Lars Erik Kristensen ◽  
Merete L Hetland ◽  
...  

ObjectiveTo study the risk of a second malignant neoplasm (SMN) and mortality in patients with rheumatoid arthritis (RA) with a history of a primary cancer diagnosis and treated with biological disease-modifying antirheumatic drugs (bDMARD).MethodsAmong patients with RA (n=15 286) registered in the DANBIO Register during 2000–2011, 1678 had a primary cancer according to the Danish Cancer Registry. HRs for SMN and death were calculated.ResultsDuring follow-up there were 279 patients with RA contributing person-years to the bDMARDs use before their primary cancer diagnosis, 220 to the only after, 92 to the both before and after, while 1203 patients with RA contributed to the non-use strata. Ever use of bDMARDs was associated with a HR of 1.11 (95% CI 0.74 to 1.67) for developing a SMN compared with non-use (cancer site adjusted). The HR for death associated with bDMARD use before the primary cancer diagnosis was increased 1.53 (95% CI 1.13 to 2.09). After further adjustment for extent of the primary cancer, the HR for death was 1.20 (95% CI 0.88 to 1.63) for bDMARDs use before cancer, 1.36 (95% CI 0.78 to 2.39) for bDMARD use only after cancer and 1.22 (95% CI 0.70 to 2.13) for use both before and after the cancer.ConclusionsAmong patients with RA with a history of cancer, treatment with bDMARDs was not associated with increased risk of SMN. No clear conclusion can be drawn regarding mortality in bDMARD-treated patients with RA.


2009 ◽  
Vol 27 (18_suppl) ◽  
pp. CRA6501-CRA6501 ◽  
Author(s):  
P. C. Nathan ◽  
K. K. Ness ◽  
M. M. Hudson ◽  
M. Mahoney ◽  
J. S. Ford ◽  
...  

CRA6501 Background: Childhood cancer survivors may develop a second malignant neoplasm (SMN) and require surveillance to detect new cancers. Methods: We surveyed survivors and siblings from the CCSS, a cohort study of patients who have survived ≥5 years after a diagnosis of childhood cancer from 1970–86. We assessed compliance with the American Cancer Society's (ACS) guidelines for surveillance mammography, colonoscopy and PAP smears, and compared them to a matched population comparison group drawn from the 2003 National Health Interview Survey. Further, we examined compliance with the Children's Oncology Group (COG) guidelines for more frequent colonoscopy, mammography and skin exams in survivors at high risk for cancers of the colon (≥30 Gy pelvic, abdominal or spinal radiation), breast (≥ 20 Gy breast radiation in females) or skin (any radiation). Proportions screened were compared between groups with adjusted generalized estimating equations or log-binomial regression models. Results: There were 8318 survivors (50.6% male, mean age at interview 31.2 ± 7.3 years), 2661 siblings and 8318 population controls. 141/829 (17.6%), 592/855 (70.4%) and 3362/3690 (92.6%) eligible survivors reported a colonoscopy, mammogram, or PAP smear per ACS guidelines. Survivors were less likely than siblings (odds ratio [OR] 0.30; 95% confidence interval [CI] 0.18–0.49) and population controls (OR 0.63; CI 0.50–0.80) to have a colonoscopy, and less likely than siblings to have a PAP smear (risk ratio [RR] 0.98; CI 0.97–0.99). However, they were more likely than siblings (RR 1.14; CI 1.03–1.27) and population controls (RR 1.05; CI 1.01–1.10) to have a mammogram. Among survivors at increased risk for a SMN, only 92/809 (11.4%) reported a colonoscopy within the COG recommended 5-year period, 164/537 (30.5%) reported a mammogram within a 1-year period and 1288/4833 (26.7%) reported a skin exam. Care at a cancer center was associated with mammography (RR 1.91; 95% CI 1.02–1.27) and skin exam (RR 1.55; 95% CI 1.22–196) in high-risk patients. Conclusions: Childhood cancer survivors are not screened adequately for SMNs. Surveillance is very poor amongst those at highest risk for colon, breast, or skin cancer. Survivors and their physicians need education about the importance of surveillance. No significant financial relationships to disclose.


2009 ◽  
Vol 27 (9) ◽  
pp. 1440-1445 ◽  
Author(s):  
Susanne O. Dalton ◽  
Thomas Munk Laursen ◽  
Lone Ross ◽  
Preben Bo Mortensen ◽  
Christoffer Johansen

Purpose As more people survive cancer, it is necessary to understand the long-term impact of cancer. We investigated whether cancer survivors are at increased risk for hospitalization for depression. Methods We linked data on all 5,703,754 persons living in Denmark on January 1, 1973, or born thereafter to the Danish Cancer Registry and identified 608,591 adults with a diagnosis of cancer. Follow-up for hospitalization for depression in the Danish Psychiatric Central Register from 1973 through 2003 yielded 121,227,396 person-years and 121,304 hospitalizations for depression. The relative risk (RR) for depression among cancer survivors relative to the cancer-free population was estimated by Poisson regression analysis with adjustment for age and period and stratified by sex, site of cancer, and extent of disease. Results The risk for depression in the first year after a cancer diagnosis was increased, with RRs ranging from 1.16 (95% CI, 0.90 to 1.51) in women with colorectal cancer to 3.08 (95% CI, 1.88 to 5.02) in men with brain cancer. Decreasing but still significant excess risks during subsequent years were observed for most specific cancers. The risk remained increased throughout the study period for both men and women surviving hormone-related cancers, for women surviving smoking-related cancers, and for men surviving virus- and immune-related cancers. Conclusion This study confirms an increased risk for depression in patients facing a disruptive event like cancer. Early recognition and effective treatment are needed to prevent admission of cancer survivors for depression.


Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1402
Author(s):  
Po-Feng Lee ◽  
Chung-Yi Li ◽  
Yen-Chin Liu ◽  
Chang-Ta Chiu ◽  
Wen-Hsuan Hou

(1) Background: The prevalence of opioid use in Taiwan increased by 41% between 2002 and 2014. However, little is known regarding the risk of mortality among long-term opioid analgesics users who do not have cancer. This study investigated this mortality risk with an emphasis on the calendar year and patients’ age and sex. (2) Methods: This retrospective cohort study included 12,990 adult individuals without cancer who were long-term users of opioid analgesics and were randomly selected from the data set of Taiwan’s National Health Insurance program from 2000 to 2012. They were then followed up through 2013. Information on the underlying causes of death was retrieved from the Taiwan Death Registry. Age, sex, and calendar year-standardized mortality ratios (SMRs) of all-cause and cause-specific mortality were calculated with reference to those of the general population. (3) Results: With up to 14 years of follow-up, 558 individuals had all-cause mortality in 48,020 person-years (cumulative mortality: 4.3%, mortality rate: 11.62 per 1000 person-years). Compared with the general population, the all-cause SMR of 4.30 (95% confidence interval (95% CI): 3.95–4.66) was significantly higher: it was higher in men than in women, declined with calendar year and age, and was significantly higher for both natural (4.15, 95% CI: 3.78–4.53) and unnatural (5.04, 95% CI: 3.88–6.45) causes. (4) Conclusions: Long-term opioid analgesics use among individuals without cancer in Taiwan was associated with a significantly increased risk of mortality. The notably increased mortality in younger adults warrants attention. Strategies to reduce long-term opioid analgesics use, especially their overuse or misuse, are in an urgent need.


Author(s):  
Daniela Esposito ◽  
Oskar Ragnarsson ◽  
Gudmundur Johannsson ◽  
Daniel S Olsson

Abstract Context Whether cancer risk in acromegaly is increased remains controversial. Also, the risk of benign tumors has been little studied. Objective To investigate the incidence of benign and malignant tumors in acromegaly in a nationwide population-based study. Design Adult patients diagnosed with acromegaly between 1987 and 2017 were identified in the Swedish National Patient Registry. The diagnoses of benign and malignant tumors were recorded. Standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) for neoplasms with 95% confidence intervals (CIs) were calculated using the Swedish general population as reference. Results The study included 1296 patients (52% women). Mean (SD) age at diagnosis was 51.6 (14.7) years. Median (range) follow-up time was 11.7 (0-31) years. Overall, 186 malignancies were identified in acromegalic patients compared to 144 expected in the general population (SIR 1.3; 95% CI, 1.1-1.5). The incidence of colorectal and anal cancer (SIR 1.5; 95% CI, 1.0-2.2), and renal and ureteral cancer (SIR 4.0; 95% CI, 2.3-6.5) was increased, whereas the incidence of malignancies of the respiratory system, brain, prostate, and breast was not. Only three cases of thyroid cancer were recorded. Mortality due to malignancies was not increased (SMR 1.1; 95% CI, 0.9-1.4). Incidence of benign tumors was increased more than 2-fold (SIR 2.4; 95% CI, 2.1-2.7). Conclusions Patients with acromegaly had an increased risk of both benign and malignant tumors including colorectal and anal cancer, and renal and ureteral cancer. Whether this is associated with acromegaly itself or due to more intensive medical surveillance remains to be shown.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20017-e20017
Author(s):  
Lauren Wiznia ◽  
Leah M Ferrucci ◽  
Susan T Mayne ◽  
Anees B. Chagpar

e20017 Background: Tanning bed use increases the incidence of nonmelanoma skin cancer (NMSC), however utilization of indoor tanning after diagnosis in this population is not well-studied. We sought to determine if tanning bed use among NMSC survivors differed from the general population. Methods: The National Health Interview Survey is an annual population-based survey that is representative of the civilian US population. We utilized the 2010 cancer supplement to evaluate self-reported tanning bed use in the previous 12 months in self-reported NMSC survivors compared to individuals without a history of skin cancer. Results: In 2010, 24,941 people were surveyed, 1.85% of whom had a self-reported history of NMSC. On univariate analysis, NMSC survivors were significantly less likely to use tanning beds in the previous 12 months (2.16 vs. 5.61%, p < 0.001). On multivariate analysis, however, NMSC survivors were equally likely to use tanning beds as those who had never had skin cancer (see Table). Conclusions: When controlling for other sociodemographic factors, NMSC survivors were no less likely to use tanning beds than the general population. These findings suggest a need to better educate NMSC survivors about the increased risk of future skin cancers with ongoing tanning bed use. [Table: see text]


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10558-10558
Author(s):  
Iliana Carolina Lega ◽  
Jason D Pole ◽  
Peter Austin ◽  
Cindy Lau ◽  
Paul C. Nathan ◽  
...  

10558 Background: Cure rates for childhood cancer have improved significantly over the last three decades. Diabetes has emerged as a delayed side-effect of treatment for childhood cancer. Methodologic limitations may have led to underestimation of the risk for diabetes in previous studies. Understanding the extent of diabetes risk and identifying risk factors for diabetes is imperative for improving screening and prevention strategies in this population. Methods: We used the Ontario population-based cancer registry and administrative health databases to evaluate the risk of diabetes in adult survivors of childhood cancer. Diabetes was measured using a validated algorithm. Survivors were compared to age and sex-matched controls from the general population using a multivariable, cause-specific hazard regression model where death and development of another cancer was treated as a competing risk. Results: We identified 10,438 1-year survivors of childhood cancer diagnosed prior to age 21 years between January 1st, 1990 and December 31st, 2010. Mean age at cancer diagnosis was 10.7 years (standard deviation [SD] 6.8) and the mean follow up was 11.2 years (SD 6.9). In multivariable models adjusted for rurality and income status, cancer survivors had a 55% increased rate of developing diabetes compared to matched controls (HR 1.55, 95% CI 1.31-1.83). Individuals treated for cancer between age 6-10 years (HR 4.01, 2.33-6.91) had the highest increased rate for diabetes among age categories. Leukemia (HR 2.39, 1.74-3.27) and lymphoma (HR 1.61, 1.12-2.31) was also associated with an increased risk for diabetes compared to the general population. Conclusions: Our study provides evidence of an increased risk for diabetes in adult survivors of childhood cancer. The increased risk is highest among those treated at younger ages, and after treatment for leukemia and lymphoma. Future research is warranted to identify optimal ways for diabetes screening and prevention in this population. Given the burden of cardiovascular disease in survivors, identifying and treating diabetes early may help improve overall morbidity and mortality.


2014 ◽  
Vol 146 (5) ◽  
pp. S-408
Author(s):  
Yezaz A. Ghouri ◽  
Sachin Batra ◽  
Nirav C. Thosani ◽  
Sushovan Guha

2018 ◽  
Vol 212 (4) ◽  
pp. 227-233 ◽  
Author(s):  
Antti Mustonen ◽  
Solja Niemelä ◽  
Tanja Nordström ◽  
Graham K. Murray ◽  
Pirjo Mäki ◽  
...  

BackgroundThe association between cannabis use and the risk of psychosis has been studied extensively but the temporal order still remains controversial.AimsTo examine the association between cannabis use in adolescence and the risk of psychosis after adjustment for prodromal symptoms and other potential confounders.MethodThe sample (n = 6534) was composed of the prospective general population-based Northern Finland Birth Cohort of 1986. Information on prodromal symptoms of psychosis and cannabis use was collected using questionnaires at age 15–16 years. Participants were followed up for ICD-10 psychotic disorders until age 30 years using nationwide registers.ResultsThe risk of psychosis was elevated in individuals who had tried cannabis five times or more (hazard ratio, (HR) = 6.5, 95% CI 3.0–13.9). The association remained statistically significant even when adjusted for prodromal symptoms, other substance use and parental psychosis (HR = 3.0, 95% CI 1.1–8.0).ConclusionsAdolescent cannabis use is associated with increased risk of psychosis even after adjustment for baseline prodromal symptoms, parental psychosis and other substance use.Declaration of interestNone.


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