Socioeconomic predictors of suicide risk among cancer patients in the United States: A population-based study |
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| Institution: | 1. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark;2. Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA;3. Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark;1. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;2. Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;3. Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;1. Universidad de Las Palmas de Gran Canaria, Calle Juan de Quesada 30, 35001 Las Palmas de Gran Canaria, Spain;2. Dermatology Department, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain;3. Research Unit, Hospital Universitario de Gran Canaria Doctor Negrín, Barranco de la Ballena s/n, 35010 Las Palmas de Gran Canaria, Spain;1. Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy;2. Piacenza Cancer Registry, Local Health Unit, Piacenza, Italy;3. Parma Cancer Registry, University Hospital of Parma, Parma, Italy;4. Reggio Emilia Cancer Registry, Epidemiology Unit, Local Health Unit-IRCCS Reggio Emilia, Reggio Emilia, Italy;5. Modena Cancer Registry, Public Health Department, Local Health Unit Modena, Modena, Italy;6. Romagna Cancer Registry, Romagna Cancer Institute, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, IRST, IRCCS, Meldola, Forlì, Italy;7. Department of Experimental and Diagnostic Medicine, University of Ferrara, Ferrara, Italy;8. Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Local Health Authority Ferrara, Ferrara, Italy;1. Cancer Research Centre, Cancer Council Queensland, Brisbane, Australia;2. School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Brisbane QLD 4059, Australia;3. Cancer Research Division, Cancer Council New South Wales, Kings Cross, NSW 1340, Australia;4. Sydney School of Public Health, University of Sydney, NSW 2006, Australia;5. Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Parklands Drive, Southport QLD 4222, Australia;6. School of Mathematical Sciences, Queensland University of Technology, Gardens Point, Brisbane QLD 4000, Australia;1. East Tallinn Central Hospital, Oncology Center, Ravi St 18, 10138 Tallinn, Estonia;2. National Institute for Health Development, Department of Epidemiology and Biostatistics, Hiiu St 42, 11619 Tallinn, Estonia;3. West Tallinn Central Hospital, Womens’ Clinic, Paldiski St 68, 10617 Tallinn, Estonia;4. Tartu University Hospital, Haematology and Oncology Clinic, L. Puusepa St 1A, 50406 Tartu, Estonia |
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| Abstract: | ObjectiveTo assess the socioeconomic predictors of suicide risk among cancer patients in the United States.MethodsCancer patients available within Surveillance, Epidemiology and End Results (SEER) database who were diagnosed between 2000–2010 have been reviewed. Linkage analysis to Census 2000 SF files was conducted to determine area-based socioeconomic attributes. Observed/ Expected ratios were calculated for the overall cohort as well as for clinically and socioeconomically defined subgroups. “Observed” is the number of observed completed suicide cases in the studied cohort; while “Expected” is the number of completed suicide cases in a demographically similar cohort within the United States and within the same period of time.ResultsThe current study reviews a total of 3,149,235 cancer patients (diagnosed 2000–2010) within the SEER database. Regarding socioeconomic county attributes, higher risk of suicide seems to be associated with lower educational attainment (O/E for counties with > 20% individuals with less than high school education: 1.41; 95% CI: 1.35–1.47), poverty rates (O/E for counties with > 5% individuals below poverty line: 1.39; 95% CI: 1.34–1.43), unemployment rates (O/E for counties with >5% families below poverty line: 1.36; 95% CI: 1.31–1.41) and less people living in urban areas (O/E for counties with < 50% individuals living in urban areas: 1.63; 95% CI: 1.50–1.77). On the other hand, risk of suicide seems to be inversely related to a higher representation of foreign-born individuals (O/E for counties with < 5% foreign-born individuals: 1.56; 95% CI: 1.47–1.65); and inversely related to a higher representation with recent immigrants to the US (O/E for counties with < 5% recent immigrants: 1.33; 95% CI: 1.29–1.38).ConclusionsCancer patients living in a socioeconomically vulnerable environment (lower educational status, poverty, and unemployment) seem to have higher suicide risk compared to other cancer patients. |
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| Keywords: | Suicide Socioeconomic status SES United States |
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