Abstract
Introduction: Suicide is a threat to cancer survivorship, and a known non-cancer competing cause of death among cancer survivors. In fact, the risk of suicide among cancer survivors is more than double that of the general population, depending on the cancer site. While several factors like age, gender, race, and cancer site are associated with suicide, studies on the potential impact of marriage, a marker for social support, on the risk of suicide among cancer survivors have been inconclusive. This study aimed to examine the impact of marital status on the risk of suicide, and to determine whether there are differences in the effect of marital status on suicide risk based on cancer sites.
Methods: Patients with head and neck (n=162,701), pancreatic (n=127,831), stomach (n=80,839), and lung/bronchus cancer (n=605,274) from the Surveillance, Epidemiology, and End Results (SEER) 18 database diagnosed from 2007-2015 were included (total n=976,645). These cancer sites were selected as they have the highest suicide rates of all cancers. Competing risks proportional hazards models estimated the association between marital status and death from suicide for each of the four cancer sites while controlling for sociodemographic and clinical covariates. These models yielded adjusted hazard ratios (aHR) and 95% confidence intervals (CI).
Results: The patient cohort was mostly male (57%), non-Hispanic white (74%), married/partnered (51%), and had a mean age of 67 years. For stomach cancer, marital status was not associated with death from suicide. For pancreatic, lung, and HNC, divorced/separated patients were more likely to commit suicide than married/partnered patients (aHR range 1.59-2.92). For lung (aHR=1.47, 95% CI 1.14, 1.92) and HNC (aHR=1.31, 95% CI 1.01, 1.70), never-married patients were more likely to commit suicide than married/partnered patients.
Conclusions: Being married was protective against suicide among the cancer survivors in our study, except for stomach cancer survivors. However, the effect of marital status on suicide risk was greater among head and neck cancer survivors than lung, pancreatic, and stomach cancer survivors. It is critical that survivors receive as much support as possible to mitigate suicide risks.
Citation Format: Nosayaba Osazuwa-Peters, Matthew C. Simpson, Eric Adjei Boakye. Differences in the impact of marital status on risk of suicide among cancer survivors based on cancer sites [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B014.
RSS Feeds