Incidence of Suicide and Association with Palliative Care among Patients with Advanced Lung Cancer
Year: 2018
Type: article
Abstract: To the Editor:Suicide is a leading cause of death in the United States, and rates are increasing.Among veterans, the rate is significantly higher compared with adjusted rates in the U.S. population (1).Increased suicide rates also exist among patients with cancer, and patients with lung cancer are at particularly high risk (2).Among patients with advanced cancer, the desire for hastened death was associated with high symptom burden, and low physical functioning and social support (3).Depression is also a risk factor for suicide among patients with cancer (4), which may contribute to the reduced survival observed among these patients (5).Specialist-delivered palliative care is associated with improvements in factors known to reduce suicide risk ( 6).This study will characterize suicide rates among patients with advanced lung cancer in the Veterans Health Administration and determine the association with palliative care. MethodsWe identified 23,538 patients with advanced lung cancer (stages IIIB and IV) diagnosed January 2007-December 2013, using the Veterans Affairs (VA) Central Cancer Registry.Registry data meet established standards of the Commission on Cancer.Study methods were reported previously (7).Cause of death (COD) was obtained from the joint Department of Veterans Affairs/Department of Defense Suicide Data Repository (SDR), which combined their efforts in merging suicide and COD data to establish a repository.Acquisition of data for the SDR from the National Death Index was supported with collaboration from the National Center for Health Statistics.Additional repository sources include the Social Security Administration Death Register, Military Mortality Database, and VA User Master File.Repository data were available through December 2013.Patients were considered to have committed suicide if cause of death was listed as ICD9-CM: E950.x or ICD10-CM: X60-X84.Patients with unknown COD were excluded (,1%).Palliative care was defined as a specialist-delivered palliative care encounter received after a lung cancer diagnosis determined on the basis of VA inpatient, outpatient, and fee-based encounter data (8).Patients were dichotomized by COD, and descriptive statistics are presented.Suicide rates, by year, were calculated per 100,000 person-years (number of suicides divided by person-years of survival).VA general population suicide rates (1) standardized by age, sex, and year of death, to match our cohort distribution, were compared with rates in our cohort.
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2883900600