Of all cancers, people with lung cancer are at greatest risk of committing suicide, finds new research presented at the American Thoracic Society’s 2017 international conference.

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Compared with suicide rates in the three most common types of non-skin cancer, lung cancer-associated suicide rates are significantly higher.

According to the American Cancer Society, excluding skin cancer, lung cancer is the second most common form of cancer in the United States and the leading cause of cancer-associated death for both men and women.

The symptoms of lung cancer are not often noticed until it has spread throughout the lungs or to other parts of the body. Due to the lack of symptoms in the early stages, the outlook for lung cancer is not as good as some other cancer types.

Lung cancer survival rates vary widely and depend on how early the condition is diagnosed, how far it has spread, and the person’s general health at the time of diagnosis. Early diagnosis can make a significant difference to survival rates.

Previous research has reported that the social and psychological distresses connected with a cancer diagnosis can sometimes lead to an increase in the number of suicides compared with the general population.

In the new study, researchers aimed to explore suicide rates specifically associated with lung cancer compared with the general population, as well as with the three most common non-skin types of cancer: breast, prostate, and colorectal.

Mohamed Rahouma, a post-doctoral cardiothoracic research fellow at Weill Cornell Medical College and New York-Presbyterian Hospital, both in New York, led the research.

Rahouma and his fellow investigators used a large national database called the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute to analyze cancer-associated suicide deaths. SEER provides data on cancer statistics to try to decrease cancer burden among the U.S. population.

Suicide deaths were evaluated among 3,640,229 patients in the SEER database for all cancer types, and individually for lung, breast, prostate, and colorectal cancers.

Over a period of 40 years, there were 6,661 cancer diagnosis-related suicides. Researchers found that suicide rates in people with any cancer were 60 percent higher than the general population. Furthermore, compared with the general population, breast cancer and prostate cancer suicide rates were 20 percent greater. There was also an increased risk of 40 percent among colorectal cancer patients.

The most elevated rates of suicide were seen in people with lung cancer. Suicide rates among lung cancer patients were 420 percent higher than the general population. In particular, Asian patients were identified as having a more than 13-fold rise in suicides, while male patients had an almost ninefold increase.

Other factors that influenced and elevated suicide risk were being widowed, being older, rejecting surgical treatment for the condition, and having a type of lung cancer that is difficult to treat (known as metastatic).

We wanted to see what the impact of one of life’s most stressful events is on patients. I think it’s fair to say that most clinicians don’t think about suicide risk in cancer patients. This study, I hope, will change that by making us more aware of those at greatest risk of suicide so that this catastrophe in the care of our patients doesn’t happen.”

Mohamed Rahouma

Over the 40-year period of the study, suicide rates decreased, note the authors. Suicide rates notably reduced among lung cancer patients compared with breast, prostate, and colorectal cancers.

“While cancer diagnosis counseling is an established practice, especially if a patient seems depressed, referral for ongoing psychological support and counseling typically does not happen. This represents a lost opportunity to help patients with a devastating diagnosis,” Rahouma concludes.

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