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Suicide and Accidental Death Among Women with Primary Ovarian Cancer: A population-based study
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  • Ying Chen,
  • Kaixu Yu,
  • Qingqing Zhu,
  • Weicheng Tang,
  • Dan Chen,
  • Liru Xue,
  • Jinjin Zhang,
  • Su Zhou,
  • Jun Dai,
  • Yan Jin,
  • Meng Wu,
  • SHIXUAN WANG
Qingqing Zhu
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Weicheng Tang
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Jinjin Zhang
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SHIXUAN WANG
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Abstract

Objective To determine the relative risk of suicide and accidental death among patients with ovarian cancer to that of the general population, and to identify risk factors associated with suicide and accidental death. Design The surveillance, epidemiology, and end results (SEER) registry provided ovarian cancer data from 18 registries. Setting Surveillance, Epidemiology, and End Results database. Population The study population comprised 149,204 patients. Methods The standardized mortality ratios (SMRs) were calculated and Fine-Gray models were fitted, with stratifications on demographic and tumor-related characteristics. Main outcome measures The standardized mortality ratios. Results Women with ovarian cancer had a higher risk of suicide and accidental death than the cancer-free group (SMR=1.86; 95% CI [1.54-2.25] and SMR=1.54; 95% CI [1.39-1.71]). Subgroup analysis indicated that only patients with type II epithelial ovarian cancer (SMR=2.31; 95% CI [1.83-2.91]) had an increased risk of suicide, and those with type I and type II epithelial ovarian cancer (SMR=1.65; 95% CI [1.39-1.97] and SMR=1.49; 95% CI [1.30-1.70]) were at a higher risk of accidental death. Patients with ovarian cancer who were younger, white, diagnosed with high-grade, non-metastatic cancer and pelvic exenteration were at a higher risk of suicide. Additionally, pelvic exenteration increased the risk of suicide but not the risk of accidental death among these women. Conclusion Women with ovarian cancer had a higher risk of suicide and accidental death compared with the general population. Clinicians should identify high-risk subgroups of ovarian cancer patients for suicide and accidental death as early as possible, with appropriate prevention strategies.