Suicide among cancer patients: adolescents and young adult (AYA) versus all-age patients

Huaqiang Zhou, Wei Xian, Yaxiong Zhang, Yunpeng Yang, Wenfeng Fang, Jiaqing Liu, Jiayi Shen, Zhonghan Zhang, Shaodong Hong, Yan Huang, Li Zhang


Background: Many researchers have studied suicide risk factors of patients with one specific cancer. But there is no comprehensive study to compare suicide issues between adolescents and young adult (AYA) group and all-age groups in a pan-cancer view.
Methods: Patients diagnosed with 20 solid malignancies were identified from SEER database. Multivariable logistic regression was operated to find out risk factors of suicide.
Results: Male sex has less impact on AYA than all-age patients (OR 2.72, 95% CI: 2.23–3.31, P<0.001 vs. OR 4.64, 95% CI: 4.37–4.94, P<0.001), while white race (OR 3.28, 95% CI: 2.02–5.77, P<0.001 vs. OR 3.40, 95% CI: 3.02–3.84, P<0.001) and unmarried status (OR 1.51, 95% CI: 1.24–1.83, P<0.001 vs. OR 1.39, 95% CI: 1.33–1.46, P<0.001) have similar impact on AYA and all-age groups. Localized cancer stage may have stronger impact on AYA than all-age (OR 2.90, 95% CI: 1.83–4.84; P<0.001 vs. OR 1.76, 95% CI: 1.61–1.92; P<0.001), while surgery only influence all-age (OR 1.14, P=0.451 vs. 1.24, P<0.001). Within 5 years from cancer diagnosis, longer survival time is associated with higher suicide risk of both all-age and AYA patients.
Conclusions: Male sex, white race and unmarried status, earlier cancer stage and longer survival time within 5 years are similar prevalent risk factors for both AYA group patients and all-age patients. It is not necessary to pick AYA cancer patients out when considering suicide risk of cancer patients.