Investigators have found that among all cancer survivors, male adolescents and young adults (AYAs) may have the highest rate of suicide-related mortality, according to a recent study published by Matsuo et al in JAMA Network Open.
Cancer is becoming more common among young patients, and cancer survivors are more likely to struggle with anxiety, depression, and thoughts of suicide, according to the American Cancer Society (ACS) and the National Comprehensive Cancer Network.
Study Methods and Results
In the recent study, the investigators examined suicide rates by gender among AYA patients with cancer. They used data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program to assess about 4.5 million deaths among cancer survivors between 2000 and 2021. The investigators then divided the data into three age groups—15 to 39 years, 40 to 59 years, and 60 years or older—and further divided each group by male or female sex.
The study found that in 2000, 4.9 deaths per 1,000 deaths among male AYA patients with cancer were related to suicide. The suicide rates among all other age/gender cancer survivor groups ranged from 0.4 to 3.1 per 1,000 deaths.
The investigators characterized the increasing suicide rate among this patient population as alarming. They reported that the number of suicide-related deaths in the AYA male cancer survivor group aged 15 to 39 years increased threefold during the 21-year study period. In 2021, 1 in 65 deaths among the group was attributed to suicide, and the number of suicide-related deaths per 1,000 deaths among male AYA patients with cancer increased to 15.4. Although suicide-related deaths increased among other cancer survivor groups, the rates were much lower compared with those of the male AYA patients with cancer, ranging from 0.6 to 7.4 per 1,000 deaths.
In addition, the investigators determined that thyroid cancer, testicular cancer, and melanomas of the skin were the three most common cancer diagnoses leading to suicide among male AYA patients with cancer. According to the ACS, these three cancer types are among those with the highest 5-year survival rates.
Conclusions
The investigators did not have access to certain information about the patients—including mental health status prior to cancer diagnosis, the reason or method of suicide-related death, patients’ cancer prognoses, and status of the cancer such as disease recurrence or remission—at the time of death.
Despite these limitations, the investigators indicated that their findings warranted a call for attention focused on the suicide rate of AYA patients, specifically males. They recommend that AYA patients with cancer be provided with more long-term support and resources that could potentially reverse this trend.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
