Strengths and Limitations
Despite many important findings of an association between ovarian cancer and risk of suicide and accidental death, there are some limitations in our study. First, the SEER database does not contain detailed information regarding chemoradiotherapy such as cycles and dosage, which renders it difficult to evaluate the impact of chemoradiotherapy on the risk of suicide and accidental death. Second, data on psychiatric status, quality of life, and social support are also unavailable in the SEER database. Third, data on a history of psychiatric disorders, complications of cancer and treatment, the quality of life, and social support are also unavailable in the SEER database, therefore, we cannot assess the direct association between these factors and the risk of suicide and accidental death among patients with ovarian cancer. Nevertheless, this study is the first large population-based study on the risk of suicide and accidental death in patients with ovarian cancer. Hence, the results of the study are reliable and applicable to the rest of the population.