Nosayaba Osazuwa-Peters1, Lauren D Arnold2, Travis M Loux3, Mark A Varvares4, Mario Schootman3. 1. Saint Louis University School of Medicine, Department of Otolaryngology-Head and Neck Surgery, St. Louis, United States; Saint Louis University Cancer Center, St. Louis, United States; Saint Louis University College for Public Health and Social Justice, Department of Epidemiology and Biostatistics, St. Louis, United States. Electronic address: nosazuwa@slu.edu. 2. Saint Louis University Cancer Center, St. Louis, United States; Saint Louis University College for Public Health and Social Justice, Department of Epidemiology and Biostatistics, St. Louis, United States. 3. Saint Louis University College for Public Health and Social Justice, Department of Epidemiology and Biostatistics, St. Louis, United States. 4. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, United States.
Abstract
OBJECTIVES: Cancer diagnosis is considered an independent predictor of suicide. We aimed to determine whether gender and human papillomavirus (HPV)-relatedness are associated with increased risks of suicide in the head and neck cancer (HNC) population. MATERIALS AND METHODS: Adult patients ≥18 years with HNC were selected using the Surveillance, Epidemiology, and End Results (SEER) data from 1973 to 2014. Using anatomic sites as proxy, patients were grouped as HPV-related or not HPV-related. Standardized Mortality Ratios (SMRs) were calculated, and association between suicide, gender, HPV-relatedness were estimated as adjusted rate ratios (aRR) using multivariable Poisson regression model. RESULTS: There were 1036 suicides among 287,901 HNC patients in the study period (63 suicides per 100,000 person-years). Male patients were six times more likely to commit suicide compared to female patients (aRR = 5.74, 95% CI 3.88, 8.50); however, HPV-relatedness did not increase risk of suicide (aRR = 0.87, 95% CI 0.58, 1.29). Compared with white patients, blacks (aRR = 0.20, 95% CI 0.12, 0.33) and Hispanics (aRR = 0.25, 95% CI 0.14, 0.43) were less likely to commit suicide. Additionally, increased risks of suicide were found among the widowed (aRR = 1.48, 95% CI 1.10, 1.99) and divorced/separated (aRR = 1.30, 95% CI 1.00, 1.69), compared with married patients. CONCLUSION: Gender, not HPV-relatedness, was associated with risk of suicide in our study. We identified HNC patients more likely to commit suicide as: previously married, white, male, widowed, divorced or separated, ≥70 years. Our findings may be useful clinically in planning personalized cancer care and lifelong surveillance of HNC patients with higher risks of suicide.
OBJECTIVES:Cancer diagnosis is considered an independent predictor of suicide. We aimed to determine whether gender and human papillomavirus (HPV)-relatedness are associated with increased risks of suicide in the head and neck cancer (HNC) population. MATERIALS AND METHODS: Adult patients ≥18 years with HNC were selected using the Surveillance, Epidemiology, and End Results (SEER) data from 1973 to 2014. Using anatomic sites as proxy, patients were grouped as HPV-related or not HPV-related. Standardized Mortality Ratios (SMRs) were calculated, and association between suicide, gender, HPV-relatedness were estimated as adjusted rate ratios (aRR) using multivariable Poisson regression model. RESULTS: There were 1036 suicides among 287,901 HNC patients in the study period (63 suicides per 100,000 person-years). Male patients were six times more likely to commit suicide compared to female patients (aRR = 5.74, 95% CI 3.88, 8.50); however, HPV-relatedness did not increase risk of suicide (aRR = 0.87, 95% CI 0.58, 1.29). Compared with white patients, blacks (aRR = 0.20, 95% CI 0.12, 0.33) and Hispanics (aRR = 0.25, 95% CI 0.14, 0.43) were less likely to commit suicide. Additionally, increased risks of suicide were found among the widowed (aRR = 1.48, 95% CI 1.10, 1.99) and divorced/separated (aRR = 1.30, 95% CI 1.00, 1.69), compared with married patients. CONCLUSION: Gender, not HPV-relatedness, was associated with risk of suicide in our study. We identified HNC patients more likely to commit suicide as: previously married, white, male, widowed, divorced or separated, ≥70 years. Our findings may be useful clinically in planning personalized cancer care and lifelong surveillance of HNC patients with higher risks of suicide.
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