Risk factors associated with suicide among hepatocellular carcinoma patients: A surveillance, epidemiology, and end results analysis

• Published in: European journal of surgical oncology 2021-03, Vol.47 (3), p.640-648
• Main Authors: Chen, Chongfa, Jiang, Yi, Yang, Fang, Cai, Qiucheng, Liu, Jianyong, Wu, Yushen, Lin, Huapeng
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Alaska Natives - statistics & numerical data; American Indian or Alaska Native - statistics & numerical data; Asian - statistics & numerical data; Carcinoma, Hepatocellular - epidemiology; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - therapy; Child; Child, Preschool; Ethnicity - statistics & numerical data; Female; Hepatocellular carcinoma; Humans; Infant; Infant, Newborn; Liver cancer; Liver Neoplasms - epidemiology; Liver Neoplasms - pathology; Liver Neoplasms - therapy; Male; Middle Aged; Multivariate Analysis; Native Hawaiian or Other Pacific Islander - statistics & numerical data; Proportional Hazards Models; Risk factor; Risk Factors; SEER; SEER Program; Sex Factors; Suicide; Suicide - ethnology; Suicide - statistics & numerical data; United States - epidemiology; White People - statistics & numerical data; Young Adult
• ISSN: 0748-7983; 1532-2157; 1532-2157
• DOI: 10.1016/j.ejso.2020.10.001

Throughout the world, hepatocellular carcinoma (HCC) remains the primary type of liver cancer. The suicide risk was higher among patients with HCC than the general population. Hence, the purpose of this study was to confirm the suicide rates, standardized mortality ratios (SMRs), and the potential risk factors associated with suicide among HCC patients. HCC patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database during 1975–2016. Suicide rates and SMRs among these patients were calculated, and the general population of the United States (U.S.) during 1975–2016 was used as a reference. Univariable and multivariable Cox regression were taken to find out the underlying risk factors of suicide in HCC patients. There were 70 suicides identified among 102,567 individuals with HCC observed for 160,500.88 person years. The suicide rate was 43.61 per 100,000 person-years, and SMR was 2.26 (95% CI: 1.78–2.84). On Cox regression, year of diagnosis (1975–1988 vs. 2003–2016, HR: 3.00, 95% CI: 1.01–8.89, P = 0.047; 1989–2002 vs. 2003–2016, HR: 1.92, 95% CI: 1.10–3.34, P = 0.021), gender (male vs. female, HR: 8.72, 95% CI: 2.73–27.81, P