Increased suicide and cardiovascular death risk after cancer diagnosis
MedWire News: Patients are at increased risk for suicide and cardiovascular death after receiving a cancer diagnosis, according to research.
These findings, published in the New England Journal of Medicine, result from a large historical cohort study involving a sample of 6,073,240 people in Sweden from 1991 to 2006.
The researchers chose to focus on the period immediately after a cancer diagnosis in order to investigate the serious consequences of the psychological stress induced by the diagnosis itself.
They say that such investigations "may have important implications for both cancer-screening policy and organized supportive care."
Fang Fang (Karolinska Institute, Stockholm, Sweden) and team identified 534,154 patients who had received a first diagnosis of cancer during the study period; 95,786 were diagnosed with prostate cancer, 74,977 with breast cancer, 62,719 with colorectal cancer, 47,169 with melanoma or another skin cancer, 36,648 with lymphatic or hematopoietic cancer, 34,743 with lung cancer, and 13,447 with central nervous system tumors. In addition to these common forms of cancer, 26,335 patients were also grouped together who had been diagnosed with a highly fatal cancer (eg, esophageal, liver, and pancreatic cancer).
They found that, compared with cancer-free individuals, the relative risk for suicide among patients who received a cancer diagnosis was 12.6 (29 patients) during the first week after diagnosis, and 3.1 (260 patients) during the first year. The expected number of suicides, adjusting for all demographic factors in this cohort, during this year was 87, which the study authors say indicates that 173 cases were associated with cancer diagnosis. The highest relative risk was observed for cancers of the esophagus, liver, and pancreas, which are the most fatal types of cancer.
The relative risk for cardiovascular death after diagnosis was 5.6 during the first week (1318 patients) and 3.3 during the first 4 weeks (2641 patients).
Fang and colleagues say that because the greatest risk for suicide and cardiovascular death was found in patients with highly fatal cancers, and the smallest risk was observed for skin cancer diagnoses, this "probably reflects varying degrees of psychological stress in patients in whom different cancers were diagnosed."
They conclude: "Our findings suggest that a cancer diagnosis constitutes a major stressor, one that immediately affects the risk of critical fatal outcomes. We speculate that our findings show only a portion of the range of effects induced by the emotional distress associated with a cancer diagnosis."
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By Chloe McIvor