Risk factors for suicide in patients with pancreatic ductal adenocarcinoma: A population-based study

Background

Patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) face a notable risk of suicide. However, comprehensive population-based studies on suicide risk in PDAC patients have been lacking. This study seeks to explore the suicide risk in PDAC patients and identify the specific risk factors associated with suicide-related mortality.

Methods

A cohort of 101,382 PDAC patients was extracted from the Surveillance, Epidemiology, and End Results database, spanning from January 1, 2000, to December 31, 2017. The study employed the standardized mortality ratio (SMR) to assess the relative risk of suicide in PDAC patients compared to the general US population. The Nelson–Aalen estimator and the Fine and Grey method were utilized to pinpoint the risk factors linked to suicide-specific mortality.

Results

PDAC patients exhibited a 3.51-fold higher risk of suicide compared to the general US population. This risk demonstrated an upward trend over the years. Notably, individuals aged 70–74 years faced a significantly elevated risk of suicide (SMR = 5.14, 95% CI: 3.10–8.03). Furthermore, there were distinct peaks in suicide risk at 1–4- and 25–28-month post-diagnoses (SMR = 15.04 and 2.72, respectively). Factors, such as gender, chemotherapy status, and marital status, emerged as significant independent predictors of suicide-specific mortality in PDAC patients.

Conclusions

This study highlights a heightened suicide risk among PDAC patients in comparison to the general US population. It underscores the crucial need for continuous monitoring of the psychological well-being of all PDAC patients. Additionally, considering the elevated risk, the application of antidepressant therapy could be beneficial for those identified as having a higher risk of suicide.