Suicide rates increased in patients with urologic cancers
Patients with urologic cancers are more likely to attempt suicide, highlighting the need for increased psychiatric intervention for these patients at an earlier stage, according to findings presented at the European Association of Urology (EAU) 2018 Congress.
Researchers analyzed data from the UK’s Office for National Statistics to identify suicide risk in the population between 2001 and 2011. Results showed 1,222 suicide attempts and 162 completed suicides among patients diagnosed with urologic malignancies. The rate of suicide death was 49 per 100,000 patients in the urologic cancer cohort, compared with 30 per 100,000 patients with non-urologic cancers and 10.9 per 100,000 individuals in the general population. [EAU 2018, poster 68]
“The rate of suicide death was 52 per 100,000 patients in the prostate cancer cohort, 48 per 100,000 patients in the kidney cancer cohort, and 36 per 100,000 in the bladder cancer cohort,” reported investigator Dr Mehran Afshar of St George’s Hospital in London, UK.
“The ratio of suicide attempts to completed suicides was lower in patients with urological cancers compared with the general population [1:7 vs 1:25],” he continued.
The researchers also examined the association between age and suicide risk in patients with urologic cancers. Among patients with kidney cancer, those younger than 50 years of age were found to be significantly more likely to attempt suicide than their older counterparts (p=0.01). In contrast, older patients with bladder or prostate cancer were significantly more likely to attempt suicide than younger patients with the same condition (p<0.01).
Surprisingly, however, patients with kidney cancer who had fewer comorbidities were found to be more like to attempt suicide than those with more comorbidities (p=0.04).
According to the researchers, the majority of patients with urologic cancer who committed suicide were men.
“The cancer itself and the treatment involved in prostate cancer often cause significant psychosocial distress in patients,” said investigator Dr Antonio Bardoli of the Queen Elizabeth Hospital in Birmingham, UK.
“As prostate cancer is increasingly being diagnosed in younger patients, those who survive with treatment may have to live with possible sexual dysfunction or urinary or faecal incontinence for considerable periods of time. These adverse effects of treatment can cause significant distress in patients,” he continued.
Based on these findings, the investigators suggested that increased psychiatric intervention should be provided to patients with urologic malignancies at an earlier stage.
“It is important to identify patients with urologic malignancies, even those with prostate cancer who have a good prognosis, who are not getting the psychiatric support they need,” suggested Bardoli. “It would also be helpful to develop prognosticators to identify patients who are at high risk for suicide.”