Montefiore St. Luke's Cornwall Hospital, Newburgh, NY
Ahsan Ayaz , Syed Arsalan Ahmed Naqvi , Manal Imran , Akshat Saxena , Ammad Raina , Kaneez Zahra Rubab Khakwani , Ewan Kemar Cobran , Sajid Ahmad Mir , Parminder Singh , Alan Haruo Bryce , Irbaz Bin Riaz
Background: Elevated suicide risk is established in cancer patients compared with the general population. We aim to investigate the risk of SRD among individuals diagnosed with mGU cancers. Methods: Surveillance, Epidemiology, and End Results (SEER) database (2004-2020) was queried to obtain data on suicide death in adults (>20 years of age) diagnosed with mGU cancers including bladder cancer (BC), kidney cancer (KC), and prostate cancer (PC). Standardized mortality ratios (SMRs) with 95% confidence interval (CI) were computed overall and by latency period of <1, 1-5, and >5 years (y) after the initial diagnosis of mGU cancers. SMR >1 indicated increased while <1 indicated decreased SRD. Stratification was done by age (<50y, 50-70y, >70y), race (White, Black, Asian, Native American), ethnicity (Hispanic, non-Hispanic), chemotherapy, radiotherapy, surgery, and marital. Results: This analysis included 87,357 mGU patients. In overall population, the risk of suicide-related deaths was highest <1y after diagnosis (SMR: 3.29, 95% CI: 2.47-4.29) followed by 1-5y (2.61, 2.0-3.35) and >5y (1.27, 0.61-2.34) after diagnosis. With respect to race, SRD was significantly higher in Whites (3.31, 2.46-4.36) but not in Blacks (2.58, 0.31-9.33), and Asians (2.03 (0.05-11.3). In ethnic subgroups, non-Hispanics were observed to have increased SRD (3.71, 2.77-4.86) but not Hispanics (0.83, 0.1-3.0). Patients who received chemotherapy (3.74, 2.10-6.18) or those who did not receive radiotherapy (3.66, 2.68-4.89) were more likely to die from suicide. In terms of marital status, single patients had a higher SRD (4.39, 2.94-6.30) compared to those who were married (2.54, 1.65-3.76). Detailed results are outlined in the Table. Conclusions: Patients with GU malignancies are at increased risk of SRD. Targeted and timely interventions in highest risk subgroups such as Non-Hispanic patients with a recent cancer diagnosis with no partner support, may reduce the risk of SRD in patients diagnosed with mGU cancers.
Subgroup | All GU Cancers | BC | KC | PC |
---|---|---|---|---|
SMR (95 % CI) | ||||
Overall Population | 3.29 (2.47-4.29) | 5.98 (2.41-12.33) | 5.99 (3.71-9.16) | 2.21 (1.44-3.24) |
Age 50-70 years | 3.51 (2.25-5.22) | 7.58 (2.07-19.41) | 5.95 (3.08-10.4) | 1.86 (0.80-3.67) |
Age >70 years | 3.38 (2.28-4.82) | 5.27 (1.09-15.40) | 8.43 (3.85-16.0) | 2.48 (1.47-3.92) |
White | 3.31 (2.46-4.36) | 6.32 (2.54-13.02) | 5.50 (3.26-8.68) | 2.33 (1.51-3.44) |
Non-Hispanic | 3.71 (2.77-4.86) | 6.67 (2.68-13.73) | 6.60 (3.97-10.3) | 2.58 (1.68-3.77) |
Chemotherapy - Yes | 3.74 (2.10-6.18) | 2.67 (0.32-9.65) | 6.13 (3.06-10.96) | 1.37 (0.17-4.94) |
Radiotherapy - No | 3.66 (2.68-4.89) | 6.53 (2.40-14.21) | 7.57 (4.56-11.82) | 2.30 (1.42-3.52) |
Surgery - Yes | 2.28 (1.04-4.33) | 3.15 (0.65-9.21) | 2.93 (0.95-6.85) | 0.78 (0.02-4.32) |
Married | 2.54 (1.65-3.76) | 2.95 (0.36-10.67) | 4.92 (2.46-8.81) | 1.74 (0.90-3.03) |
Single | 4.39 (2.94-6.30) | 10.14 (3.29-23.66) | 7.86 (3.77-14.46) | 2.89 (1.58-4.85) |
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Abstract Disclosures
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