Suicidal and Accidental Death Risk in Different Histological Subtypes of Ovarian Cancer
Only patients with Type II epithelial ovarian cancer had an increased risk of suicide, and those with Type I and Type II epithelial ovarian cancer were at a higher risk of accidental death compared with the general population (Figure.1) . Among 102,418 patients with type II ovarian cancer, there were 72 suicides and 214 accidental deaths, accounting for 67% and 57% of all suicides and accidental deaths among ovarian cancer patients, respectively (Table.2 ). These patients had the highest risk of suicide and accidental deaths among all patients with ovarian cancer (17.49 /100,000 person-years; SMR=2.31; 95% CI [1.83-2.91] and 51.98 /100,000 person-years; SMR=1.49; 95% CI [1.30-1.70]), followed by those with sex cord ovarian cancer for suicide (16.55 /100,000 person-years; SMR=2.37; 95% CI [0.89-6.32]) and those with type I ovarian cancer for accidental death (46.68 /100,000 person-years; SMR=1.65; 95% CI [1.39-1.97]). Patients with ovarian cancer of sex cord, type I, and germ cell had an almost equal risk of suicide (16.55 /100,000 person-years; SMR=2.37; 95% CI [0.89-6.32], 8.82 /100,000 person-years; SMR=1.12; 95% CI [0.75-1.66], and 7.84 /100,000 person-years; SMR=1.67; 95% CI [0.63-4.44]) and patients with ovarian cancer of sex cord and germ cell had an almost equal risk of accidental death compared with the general population (41.39 /100,000 person-years; SMR=1.53; 95% CI [0.82-2.85] and 25.48 /100,000 person-years; SMR=1.40; 95% CI [0.81-2.40]). For type II ovarian cancer patients, those with undifferentiated ovarian cancer had the highest risk of suicide and accidental death (23.94 /100,000 person-years; SMR=3.26; 95% CI [2.18-4.86] and 77.80 /100,000 person-years; SMR=1.94; 95% CI [1.56-2.43]), followed by those with high-grade serous (15.24 /100,000 person-years; SMR=1.99; 95% CI [1.48-2.69] and 43.23 /100,000 person-years; SMR=1.30; 95% CI [1.09-1.56]) and mixed epithelial-stromal carcinoma (17.11 /100,000 person-years; SMR=2.25; 95% CI [0.94-5.41] and 47.90 /100,000 person-years; SMR=1.39; 95% CI [0.82-2.35]).