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Suicidal Ideation Among Patients with Gastrointestinal Cancer

  • Global Health Services Research
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Annals of Surgical Oncology Aims and scope Submit manuscript

A Correction to this article was published on 03 October 2023

A Correction to this article was published on 20 July 2023

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Abstract

Background

Mental illness (MI) and suicidal ideation (SI) often are associated with a diagnosis of cancer. We sought to define the incidence of MI and SI among patients with gastrointestinal cancers, as well as ascertain the predictive factors associated with SI.

Methods

Patients diagnosed between 2004 and 2016 with stomach, liver, pancreatic, and colorectal cancer were identified from the SEER-Medicare database. County-level social vulnerability index (SVI) was extracted from the Centers for Disease Control database. Multivariable logistic regression was used to identify factors associated with SI.

Results

Among 382,266 patients, 83,514 (21.9%) individuals had a diagnosis of MI. Only 1410 (0.4%) individuals experienced SI, and 359 (0.1%) committed suicide. Interestingly, SI was least likely among patients with pancreatic cancer (ref: hepatic cancer; odds ratio [OR] 0.67, 95% confidence interval [CI] 0.52–0.86; p = 0.002), as well as individuals with stage III/IV disease (OR 0.59, 95% CI 0.52–067; p < 0.001). In contrast, male (OR 1.34, 95% CI 1.19–1.50), White (OR 1.34, CI 1.13–1.59), and single (OR 2.03, 95% CI 1.81–2.28) patients were at higher odds of SI risk (all p < 0.001). Furthermore, individuals living in relative privilege (low SVI) had markedly higher risk of SI (OR 1.33, 95% CI 1.14–1.54; p < 0.001). Moreover, living in a county with a shortage of mental health professionals was associated with increased odds of developing SI (OR 1.21, 95% CI 1.04–1.40; p = 0.012).

Conclusions

Oncology care teams should incorporate routine mental health and SI screening in the treatment of patients with gastrointestinal cancers, as well as target suicide prevention towards patients at highest risk.

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  1. Department of Surgery, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA

    Erryk S. Katayama BA, Zorays Moazzam MD, Selamawit Woldesenbet PhD, Henrique A. Lima MD, Yutaka Endo MD, PhD, Lovette Azap BS, Jason Yang BS, Mary Dillhoff MD, Aslam Ejaz MD, Jordan Cloyd MD & Timothy M. Pawlik MD, PhD, MPH, MTS, MBA, FACS, FRACS (Hon.)

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Katayama, E.S., Moazzam, Z., Woldesenbet, S. et al. Suicidal Ideation Among Patients with Gastrointestinal Cancer. Ann Surg Oncol 30, 3929–3938 (2023). https://doi.org/10.1245/s10434-023-13471-x

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