Evidence map›Paper›PMID 31021430›Full record

ArticleCancer2019

Cancer diagnosis and risk of suicide after accounting for prediagnosis psychiatric care: A matched-cohort study of patients with incident solid-organ malignancies.

Zachary Klaassen, Christopher J D Wallis, Thenappan Chandrasekar, Hanan Goldberg, Rashid K Sayyid, Stephen B Williams, Kelvin A Moses, Martha K Terris, Robert K Nam, David Urbach and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  17. Mental Health in Urologic Oncology.Health psychology research · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Zachary KlaassenDepartment of Surgery, Division of Urology, University of Toronto, University Health Network, Princess Margaret Cancer Center, Toronto, Ontario, Canada.ORCID 0000-0001-7392-8916
Christopher J D WallisDepartment of Surgery, Division of Urology, University of Toronto, University Health Network, Princess Margaret Cancer Center, Toronto, Ontario, Canada.ORCID 0000-0002-5990-4026
Thenappan ChandrasekarDepartment of Surgery, Division of Urology, University of Toronto, University Health Network, Princess Margaret Cancer Center, Toronto, Ontario, Canada.ORCID 0000-0002-2173-5028
Hanan GoldbergDepartment of Surgery, Division of Urology, University of Toronto, University Health Network, Princess Margaret Cancer Center, Toronto, Ontario, Canada.ORCID 0000-0002-5777-2138
Rashid K SayyidDivision of Urology, Medical College of Georgia-Augusta University, Augusta, Georgia.
Stephen B WilliamsDivision of Urology, The University of Texas Medical Branch at Galveston, Galveston, Texas.ORCID 0000-0002-2683-2185
Kelvin A MosesDepartment of Urological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Martha K TerrisDivision of Urology, Medical College of Georgia-Augusta University, Augusta, Georgia.
Robert K NamInstitute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
David UrbachInstitute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Peter C AustinInstitute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Paul KurdyakInstitute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Girish S KulkarniDepartment of Surgery, Division of Urology, University of Toronto, University Health Network, Princess Margaret Cancer Center, Toronto, Ontario, Canada.

Funding

Vanderbilt Clinical Oncology Research Career Development ProgramK12CA090625 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Debra L. Friedman, Paula Jill Hurley · 2001 to 2026
$16.9M
NCI NIH HHS K12 CA090625
6 · The paper itself

Abstract

backgroundPrevious studies have demonstrated an association between a diagnosis of cancer and the risk of suicide; however, they failed to account for psychiatric care before a cancer diagnosis, which may confound this relationship. The objective of this study was to assess the effect of a cancer diagnosis on the risk of suicide, accounting for prediagnosis psychiatric care utilization.

methodsAll adult residents of Ontario, Canada who were diagnosed with cancer (1 of prostate, breast, colorectal, melanoma, lung, bladder, endometrial, thyroid, kidney, or oral cancer) between 1997 and 2014 were identified. Noncancer controls were matched 4:1 based on sociodemographics, including a psychiatric utilization gradient (PUG) score (with 0 indicating none; 1, outpatient; 2, emergency department; and 3, hospital admission). A marginal, cause-specific hazard model was used to assess the effect of cancer on the risk of suicidal death.

resultsAmong 676,470 patients with cancer and 2,152,682 matched noncancer controls, there were 8.2 and 11.4 suicides per 1000 person-years of follow-up, respectively. Patients with cancer had an overall higher risk of suicidal death compared with matched patients without cancer (hazard ratio, 1.34; 95% CI, 1.22-1.48). This effect was pronounced in the first 50 months after cancer diagnosis (hazard ratio, 1.60; 95% CI, 1.42-1.81); patients with cancer did not demonstrate an increased risk thereafter. Among individuals with a PUG score 0 or 1, those with cancer were significantly more likely to die of suicide compared with controls. There was no difference in suicide risk between patients with cancer and controls for those who had a PUG score of 2 or 3.

conclusionsA cancer diagnosis is associated with increased risk of death from suicide compared with the general population even after accounting for precancer diagnosis psychiatric care utilization. The specific factors underlying the observed associations remain to be elucidated.

Indexed as

AgedCase-Control StudiesCohort StudiesFemaleHumansMaleMiddle AgedNeoplasmsOntarioPsychotherapyRisk FactorsSuicidecancermental healthpsychiatric utilizationpsycho-oncologysuicidal deathsuicide

Identifiers

PMID31021430
PMCPMC10182898

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.