A diagnosis of cancer may put teens and young adults at
risk for suicide, a new study finds.
"There is a need to support and carefully monitor this
vulnerable population," said lead researcher Donghao Lu from the
department of medical epidemiology and biostatistics at the Karolinska
Institute in Stockholm, Sweden.
The study of Swedes between the ages of 15 to 30 found that those with a cancer
diagnosis had a 60% greater risk of suicide or attempted suicide compared to
similar young people without cancer. The risk peaked the first year after
diagnosis, when it was 150% higher, the researchers found.
"Although the absolute risk of suicidal behaviour is
small among the young cancer patients, these findings do imply that the young
patients suffer from great emotional stress after the diagnosis," Lu said.
All cancer patients, regardless of age, have an elevated
risk of suicide, Lu said.
"Because adolescents and young adults are
still developing their coping strategies for stress, they may be more affected
than adults when facing major adversity such as a cancer diagnosis," he
Whether these findings, published in the Annals
of Oncology, apply to young cancer patients elsewhere is unclear.
"Given the fact that the cancer care practice and characteristics of
suicidal behaviour may be different between Sweden and other countries, it
might be a little premature to extend our findings to other populations,"
However, Lu believes there is a need for mental health care
for these young cancer patients, particularly those with pre-existing
psychiatric conditions or with poor prognosis.
"The best support should be delivered through
cooperation among different parties, including the medical professionals, psychological
professionals, family members, as well as social workers," he said.
Lanny Berman, executive director of the American
Association of Suicidology, said these findings are not new, "but this is
the first study to document that elevated risk among younger populations of
What is consistent across all the studies in this area, he
said, is the increased apprehension, distress, fear and/or terror that comes
soon after diagnosis, "hence the need for significant counsel and support
to help adaptation and recovery," he added.
For the study, Lu's team collected data on nearly eight million
Swedish males and females who were 15 or older between 1987 and 2009. More than
12 600 had been diagnosed with cancer.
During more than 17 years of follow-up, on average nearly 106 000 suicides or attempted suicides occurred.
Among cancer patients, 22 killed themselves more than
the 14 expected based on the general population.
The researchers said that 136
cancer patients had attempted suicide, which was more than the 80 attempts expected
based on the general population.
In total, that's an extra 64 suicides or
attempted suicides among the young cancer patients, the authors concluded. The risk for suicidal behaviours rose for most cancer
diagnoses, but not for thyroid cancer, testicular cancer or melanoma. This
might be because these cancers have a better prognosis among the young, the
However, the risk for suicidal behaviour was tripled among
young females diagnosed with cervical cancer, which is highly treatable when
caught early. That risk rose nearly six fold the first year after diagnosis.
Although more young people with mental problems attempted
suicide overall, having cancer didn't seem to up the risk for these patients.
It's possible they were undergoing treatment for their
mental problem with antidepressants or counselling that helped prevent suicidal
behaviour, the researchers suggested.
Dr Christine Moutier, medical director of the American
Foundation for Suicide Prevention, said the study shows the need to assess
young people diagnosed with cancer for their suicide risk.
"The good news is that mental health problems, in
large part, can be improved with treatment," she said.
According to the study, hanging was the most common method
of suicide and poisoning was the most frequent form of attempted suicide.
For more information on depression and cancer, visit the American Cancer Society.