Suicide in Survivors of Cancer in Childhood, Adolescence and Young Adulthood

Survivors of cancer diagnosed before the age of 25 had a more than two-fold increased risk of suicide compared to their non-cancer peers

Among 5,440 individuals diagnosed with cancer before age 25 in Norway, the hazard ratio of suicide was 2.5, and was increased both when diagnosed with cancer in childhood and during adolescence/young adulthood. Survivors of bone/soft tissue sarcomas, CNS tumours and testicular cancer were at particular risk. Although based on small numbers and the absolute risk of suicide being low, these are novel findings with important implications for establishing adequate follow-up including suicide prevention strategies for young cancer survivors. The study was published in the International Journal of Cancer.

Suicide risk in adult cancer patients is found to be elevated, but limited information exists regarding risks of suicide and non-suicidal violent deaths when diagnosed with cancer in young age.

The results are based on a linkage between several national registries, including the Norwegian Cause of Death Registry and the Cancer registry of Norway. Among the 1.2 million people born in Norway between 1965 and 1985, a total of 5,440 individuals received a cancer diagnosis before the age of 25, and these two groups were compared. They were all tracked until 2008. During follow-up, a total of 24 of the cancer survivors committed suicide.

There was no increased risk of external causes of death when excluded suicide, like traffic accidents and accidental poisoning, among others.

Maria Winther Gunnes of the Department of Global Public Health and Primary Care at the University of Bergen and colleagues research cannot look at the individual background of this increased suicide risk. She believes, however, that this can be a result of the total chronic health burden, which is something many survivors have to live with for years, often life-long, after treatment is completed. Often, these survivors do not know where to turn to for help, and they might not find the right help.

"We do not have any proper follow-up system for adult long time survivors of young age cancer," Winther Gunnes, says.

She points out that the absolute risk of committing suicide for cancer survivors is low, and that one of the drawbacks of the study is the low numbers of suicide in total.

"It is, however, important to be aware of these new findings in order to develop appropriate surveillance and intervention strategies as part of a long-term follow-up programme of these cancer survivors," says Maria Winther Gunnes.

Reference:

MW Gunnes, RT Lie, T Bjørge, et al. Suicide and violent deaths in survivors of cancer in childhood, adolescence and young adulthood-A national cohort study. International Journal of Cancer 2016; DOI: 10.1002/ijc.30474