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Risk factors associated with suicide among hepatocellular carcinoma patients: A surveillance, epidemiology, and end results analysis
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 r...
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| Published in: | European journal of surgical oncology 2021-03, Vol.47 (3), p.640-648 |
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| description | 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 |
| doi_str_mv | 10.1016/j.ejso.2020.10.001 |
| format | article |
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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 < 0.001), age at diagnosis (63–105 years old vs. 0–55 years old, HR: 2.28, 95% CI: 1.21–4.31, P = 0.011), race (white race vs. American Indian/Alaska Native, Asian/Pacific Islander, HR: 3.02, 95% CI: 1.35–6.76, P = 0.007) were independent risk factors of suicide among HCC patients.
Diagnosed in the early years (1975–2002), male sex, the older age (63–105 years old), white race, survival months (＜2 months) were significantly associated with suicide among HCC patients. For the sake of preventing suicide behaviors, the government, clinicians, and family members should take adequate measures to decrease the rate of suicide, especially in patients with high-risk factors of suicide.</description><identifier>ISSN: 0748-7983</identifier><identifier>ISSN: 1532-2157</identifier><identifier>EISSN: 1532-2157</identifier><identifier>DOI: 10.1016/j.ejso.2020.10.001</identifier><identifier>PMID: 33051117</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject><![CDATA[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]]></subject><ispartof>European journal of surgical oncology, 2021-03, Vol.47 (3), p.640-648</ispartof><rights>2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology</rights><rights>Copyright © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.</rights><rights>2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved. 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-f0e9c9560c5d9764ea4cd52db61813048a78b97df3d2dddba63e89388e48db273</citedby><cites>FETCH-LOGICAL-c455t-f0e9c9560c5d9764ea4cd52db61813048a78b97df3d2dddba63e89388e48db273</cites><orcidid>0000-0001-6996-4041</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33051117$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Chongfa</creatorcontrib><creatorcontrib>Jiang, Yi</creatorcontrib><creatorcontrib>Yang, Fang</creatorcontrib><creatorcontrib>Cai, Qiucheng</creatorcontrib><creatorcontrib>Liu, Jianyong</creatorcontrib><creatorcontrib>Wu, Yushen</creatorcontrib><creatorcontrib>Lin, Huapeng</creatorcontrib><title>Risk factors associated with suicide among hepatocellular carcinoma patients: A surveillance, epidemiology, and end results analysis</title><title>European journal of surgical oncology</title><addtitle>Eur J Surg Oncol</addtitle><description>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 < 0.001), age at diagnosis (63–105 years old vs. 0–55 years old, HR: 2.28, 95% CI: 1.21–4.31, P = 0.011), race (white race vs. American Indian/Alaska Native, Asian/Pacific Islander, HR: 3.02, 95% CI: 1.35–6.76, P = 0.007) were independent risk factors of suicide among HCC patients.
Diagnosed in the early years (1975–2002), male sex, the older age (63–105 years old), white race, survival months (＜2 months) were significantly associated with suicide among HCC patients. For the sake of preventing suicide behaviors, the government, clinicians, and family members should take adequate measures to decrease the rate of suicide, especially in patients with high-risk factors of suicide.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Alaska Natives - statistics & numerical data</subject><subject>American Indian or Alaska Native - statistics & numerical data</subject><subject>Asian - statistics & numerical data</subject><subject>Carcinoma, Hepatocellular - epidemiology</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - therapy</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Ethnicity - statistics & numerical data</subject><subject>Female</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - therapy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Native Hawaiian or Other Pacific Islander - statistics & numerical data</subject><subject>Proportional Hazards Models</subject><subject>Risk factor</subject><subject>Risk Factors</subject><subject>SEER</subject><subject>SEER Program</subject><subject>Sex Factors</subject><subject>Suicide</subject><subject>Suicide - ethnology</subject><subject>Suicide - statistics & numerical data</subject><subject>United States - epidemiology</subject><subject>White People - statistics & numerical data</subject><subject>Young Adult</subject><issn>0748-7983</issn><issn>1532-2157</issn><issn>1532-2157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9UU2LFDEUDKK4s6N_wIPk6GF7zEd3Jy0iLIurwoIgeg7p5PVMxnRnTNIjc_eHm2bWRS8eQqBeVb1HFUIvKNlQQtvX-w3sU9gwwhZgQwh9hFa04axitBGP0YqIWlaik_wCXaa0J4R0XHRP0QXnpKGUihX69cWl73jQJoeYsE4pGKczWPzT5R1OszPOAtZjmLZ4BwedgwHvZ68jNjoaN4VR4wI7mHJ6g6-LJB7Bea8nA1cYDkU-uuDD9nSF9WQxlBchzT6XdZP2p-TSM_Rk0D7B8_t_jb7dvv9687G6-_zh0831XWXqpsnVQKAzXdMS09hOtDXo2tiG2b6lknJSSy1k3wk7cMustb1uOciOSwm1tD0TfI3enX0Pcz-CNeXmqL06RDfqeFJBO_XvZHI7tQ1HJRouebFao1f3BjH8mCFlNbq0BKInCHNSrC6xcsYpKVR2ppoYUoowPKyhRC31qb1a6lNLfQtW6iuil38f-CD501chvD0ToMR0dBBVMiV6A9ZFMFnZ4P7n_xt4z7BV</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Chen, Chongfa</creator><creator>Jiang, Yi</creator><creator>Yang, Fang</creator><creator>Cai, Qiucheng</creator><creator>Liu, Jianyong</creator><creator>Wu, Yushen</creator><creator>Lin, Huapeng</creator><general>Elsevier Ltd</general><general>Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6996-4041</orcidid></search><sort><creationdate>20210301</creationdate><title>Risk factors associated with suicide among hepatocellular carcinoma patients: A surveillance, epidemiology, and end results analysis</title><author>Chen, Chongfa ; Jiang, Yi ; Yang, Fang ; Cai, Qiucheng ; Liu, Jianyong ; Wu, Yushen ; Lin, Huapeng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-f0e9c9560c5d9764ea4cd52db61813048a78b97df3d2dddba63e89388e48db273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Alaska Natives - statistics & numerical data</topic><topic>American Indian or Alaska Native - statistics & numerical data</topic><topic>Asian - statistics & numerical data</topic><topic>Carcinoma, Hepatocellular - epidemiology</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - therapy</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Ethnicity - statistics & numerical data</topic><topic>Female</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - therapy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Native Hawaiian or Other Pacific Islander - statistics & numerical data</topic><topic>Proportional Hazards Models</topic><topic>Risk factor</topic><topic>Risk Factors</topic><topic>SEER</topic><topic>SEER Program</topic><topic>Sex Factors</topic><topic>Suicide</topic><topic>Suicide - ethnology</topic><topic>Suicide - statistics & numerical data</topic><topic>United States - epidemiology</topic><topic>White People - statistics & numerical data</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Chongfa</creatorcontrib><creatorcontrib>Jiang, Yi</creatorcontrib><creatorcontrib>Yang, Fang</creatorcontrib><creatorcontrib>Cai, Qiucheng</creatorcontrib><creatorcontrib>Liu, Jianyong</creatorcontrib><creatorcontrib>Wu, Yushen</creatorcontrib><creatorcontrib>Lin, Huapeng</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Chongfa</au><au>Jiang, Yi</au><au>Yang, Fang</au><au>Cai, Qiucheng</au><au>Liu, Jianyong</au><au>Wu, Yushen</au><au>Lin, Huapeng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors associated with suicide among hepatocellular carcinoma patients: A surveillance, epidemiology, and end results analysis</atitle><jtitle>European journal of surgical oncology</jtitle><addtitle>Eur J Surg Oncol</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>47</volume><issue>3</issue><spage>640</spage><epage>648</epage><pages>640-648</pages><issn>0748-7983</issn><issn>1532-2157</issn><eissn>1532-2157</eissn><abstract>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 < 0.001), age at diagnosis (63–105 years old vs. 0–55 years old, HR: 2.28, 95% CI: 1.21–4.31, P = 0.011), race (white race vs. American Indian/Alaska Native, Asian/Pacific Islander, HR: 3.02, 95% CI: 1.35–6.76, P = 0.007) were independent risk factors of suicide among HCC patients.
Diagnosed in the early years (1975–2002), male sex, the older age (63–105 years old), white race, survival months (＜2 months) were significantly associated with suicide among HCC patients. For the sake of preventing suicide behaviors, the government, clinicians, and family members should take adequate measures to decrease the rate of suicide, especially in patients with high-risk factors of suicide.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>33051117</pmid><doi>10.1016/j.ejso.2020.10.001</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6996-4041</orcidid><oa>free_for_read</oa></addata></record> |
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| 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 |
| title | Risk factors associated with suicide among hepatocellular carcinoma patients: A surveillance, epidemiology, and end results analysis |
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