作者：SCI天天读

SCI 27 January 2022

Incidence, Timing, and Factors Associated With Suicide Among Patients Undergoing Surgery for Cancer in the US

（JAMA Oncology；IF: 33.006）

Alexandra L. Potter; Chinmay Haridas; Krista Neumann; Mathew V. Kiang; Zhi Ven Fong; Corinne A. Riddell; Harrison G. Pope Jr; Chi-Fu Jeffrey Yang

CORRESPONDENCE TO: cjyang@mgh.harvard.edu

IMPORTANCE 重要性

The risk and timing of suicide among patients who undergo surgery for cancer remain largely unknown, and, to our knowledge, there are currently no organized programs in place to implement regular suicide screening among this patient population.

癌症手术患者自杀的风险和时机尚不清楚，据我们所知，目前还没有对这些患者实施定期自杀倾向筛查的计划。

OBJECTIVE 目的

To evaluate the incidence, timing, and factors associated with suicide among patients undergoing cancer operations.

评估癌症手术患者自杀的发生率、时间和相关因素。

DESIGN, SETTING, AND PARTICIPANTS 试验设计、参与者

A Fine-Gray competing risks regression model was used to identify factors associated with an increased risk of suicide among patients in the cohort. Data were analyzed from September 2021 to January 2022.

这项基于人群的回顾性队列研究使用了监测、流行病学和最终结果项目的数据，与美国普通人群相比，分析了2000年至2016年美国15种最致命癌症手术患者的自杀率和自杀时间。Fine-Gray竞争风险回归模型用于确认队列中患者自杀风险增加的相关因素，分析了2021 9月至2022年1月的数据。

EXPOSURES 暴露因素

Surgery for cancer.

癌症术后

MAIN OUTCOMES AND MEASURES 主要结果

Incidence, compared with the general US population, timing, and factors associated with suicide after surgery for cancer.

与一般美国人口相比，癌症术后自杀的发生率、时间和相关因素。

RESULTS 结果

From 2000 to 2016, 1 811 397 patients (74.4% female; median [IQR] age, 62.0 [52.0-72.0] years) met study inclusion criteria. Of these patients, 1494 (0.08%) committed suicide after undergoing surgery for cancer. The incidence of suicide, compared with the general US population, was statistically significantly higher among patients undergoing surgery for cancers of the larynx (standardized mortality ratio [SMR], 4.02; 95% CI, 2.67-5.81), oral cavity and pharynx (SMR, 2.43; 95% CI, 1.93-3.03), esophagus (SMR, 2.25; 95% CI, 1.43-3.38), bladder (SMR, 2.09; 95% CI, 1.53-2.78), pancreas (SMR, 2.08; 95% CI, 1.29-3.19), lung (SMR, 1.73; 95% CI, 1.47-2.02), stomach (SMR, 1.70; 95% CI, 1.22-2.31), ovary (SMR, 1.64; 95% CI, 1.13-2.31), brain (SMR, 1.61; 95% CI, 1.12-2.26), and colon and rectum (SMR, 1.28; 95% CI, 1.16-1.40). Approximately 3%, 21%, and 50% of suicides were committed within the first month, first year, and first 3 years after surgery, respectively. Patients who were male, White, and divorced or single were at greatest risk of suicide.

从2000年到2016年，1811397名患者（74.4%为女性；年龄，62.0[52.0-72.0]岁）符合研究纳入标准。在这些患者中，1494人（0.08%）在癌症手术后自杀。与美国普通人群相比，喉癌（SMR，4.02；95%CI，2.67-5.81）、口腔和咽部（SMR，2.43；95%CI：1.93-3.03）、食管癌（SMR：2.25；95%CI为1.43-3.38）、膀胱癌（SMR为2.09，95%CI为1.53-2.78）、胰腺癌（SMR，2.08；95%CI，1.29-3.19）、肺癌（SMR：1.73；95%CI：1.47-2.02）、胃癌（SMR为1.70；95%CI为1.22-2.31）、卵巢癌（SMR 1.64；95%CI 1.13-2.31）、脑肿瘤（SMR 1.61；95%CI 1.12-2.26）以及结直肠癌（SMR 1.28；95%CI 1.16-1.40）。大约3%、21%和50%的自杀发生在手术后的第一个月、第一年和前三年。男性、白人、离异或单身患者自杀的风险最大。

CONCLUSIONS AND RELEVANCE 结论和相关性

In this cohort study, the incidence of suicide among patients undergoing cancer operations was statistically significantly elevated compared with the general population, highlighting the need for programs to actively implement regular suicide screening among such patients, especially those whose demographic and tumor characteristics are associated with the highest suicide risk.

在这项队列研究中，与普通人群相比，癌症手术患者的自杀发生率在统计学上显著升高，这表明需要对这些患者积极实施定期自杀倾向筛查，尤其是那些人口统计学和肿瘤特征与自杀风险最高相关的患者。

本文自其他网站，不代表健康界观点和立场。如有内容和图片的著作权异议，请及时联系我们（邮箱：guikequan@hmkx.cn）