Internal Comparisons: Predictors of Suicide and Accidental Death Based on Fine-Gray Model
The Fine-Gray model revealed that age was found to be a protective factor for suicide (HR=0.98; 95% CI [0.97-0.99]; P<0.001) but an independent risk factor for accidental death (HR=1.02; 95% CI [1.01-1.03]; P<0.001) among patients with ovarian cancer (Supplementary Table.2 ). Patients with high-grade ovarian cancer had a higher risk of suicide rather than accidental death than those with low-grade ovarian cancer. Besides, patients with localized (HR=1.85; 95% CI [1.11-3.08]; P=0.019 and HR=2.08; 95% CI [1.56-2.78]; P<0.001) or regional ovarian cancer (HR=1.97; 95% CI [1.12-3.47]; P=0.019 and HR=1.65; 95% CI [1.19-2.19]; P=0.003) had relatively higher risk of suicide and accidental death compared with those with distant ovarian cancer. The risk of suicide among patients who underwent pelvic exenteration (HR=4.14; 95% CI [1.07-15.98]; P=0.039) for ovarian cancer was approximately five times that of patients who underwent oophorectomy without hysterectomy, while there was no statistical difference in the risk of accidental death in the two groups (HR=1.03; 95% CI [0.40-2.62]; P=0.960).Figure.2 showed the cumulative incidence of suicide and accidental death among patients who underwent different types of surgery throughout follow-up. Moreover, patients with localized or regional ovarian cancer had a significantly high risk of suicide and accidental death. The high-grade cancer population had a higher rate of suicide risk while the risk of accidental death was the same as that of the low-grade cancer population.