Suicide and Cardiovascular Death after a Cancer Diagnosis
Abstract
BACKGROUND: Receiving a diagnosis of cancer is a traumatic experience that may trigger immediate adverse health consequences beyond the effects of the disease or treatment. METHODS: Using Poisson and negative binomial regression models, we conducted a historical cohort study involving 6,073,240 Swedes to examine the associations between a cancer diagnosis and the immediate risk of suicide or death from cardiovascular causes from 1991 through 2006. To adjust for unmeasured confounders, we also performed a nested, self-matched case-crossover analysis among all patients with cancer who died from suicide or cardiovascular diseases in the cohort. RESULTS: As compared with cancer-free persons, the relative risk of suicide among patients receiving a cancer diagnosis was 12.6 (95% confidence interval [CI], 8.6 to 17.8) during the first week (29 patients; incidence rate, 2.50 per 1000 person-years) and 3.1 (95% CI, 2.7 to 3.5) during the first year (260 patients; incidence rate, 0.60 per 1000 person-years). The relative risk of cardiovascular death after diagnosis was 5.6 (95% CI, 5.2 to 5.9) during the first week (1318 patients; incidence rate, 116.80 per 1000 person-years) and 3.3 (95% CI, 3.1 to 3.4) during the first 4 weeks (2641 patients; incidence rate, 65.81 per 1000 person-years). The risk elevations decreased rapidly during the first year after diagnosis. Increased risk was particularly prominent for cancers with a poor prognosis. The case-crossover analysis largely confirmed results from the main analysis. CONCLUSIONS: In this large cohort study, patients who had recently received a cancer diagnosis had increased risks of both suicide and death from cardiovascular causes, as compared with cancer-free persons. (Funded by the Swedish Council for Working Life and Social Research and others.).
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Receiving a diagnosis of a chronic medical condition, especially in the first week after a cancer diagnosis, is a precipitating factor for suicide.
“Other precipitating factors include receiving a diagnosis of a chronic medical condition, particularly in the first week after a diagnosis of cancer.17”
From Suicide (2020) · cites this paper as [17]
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- Authors
- Fang, F., Fall, K., Mittleman, M. A., Sparén, P., Ye, W., Adami, H.-O., & Valdimarsdóttir, U.
- Affiliations
- Karolinska Institutet (SE)
- Harvard University (US)
- Beth Israel Deaconess Medical Center (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2012-04-05
- Volume
- 366
- Issue
- 14
- Pages
- 1310-1318
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2146692373
- Cited by
- 455
- References
- 29
- Citations by year
- 2026: 11 · 2025: 30 · 2024: 28 · 2023: 26 · 2022: 41 · 2021: 36 · 2020: 35 · 2019: 30 · 2018: 34 · 2017: 41 · 2016: 17 · 2015: 28 · 2014: 27 · 2013: 46 · 2012: 25
- FWCI
- 19.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Keywords
- suicide, cardiovascular mortality, cancer diagnosis, case-crossover analysis
- MeSH terms
- Cardiovascular Diseases, Female, Humans, Male, Neoplasms, Regression Analysis, Risk, Suicide, Sweden, Cohort Studies, Incidence, Poisson Distribution
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