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Patients with cancer have a 20% greater risk of suicide

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Cancer patients face a 20% higher risk of suicide than the general population, according to the first study of its kind for England.

The startling figures highlight the need for better emotional support for people with cancer, according to England’s public health champion.

The study by Public Health England found that the highest risk of suicide for someone with cancer was within the first six months of diagnosis.

The agency said that health professionals should consider the risk of suicide in cancer patients to help avoid potentially preventable deaths.

The study, a partnership between PHE and University College London, included 4,722,099 adults aged 18 to 99 years who received cancer diagnoses between 1995 and 2015 and were identified using the National Cancer Registration and Analysis Service for England.

The researchers followed the patients until 2017, assessing deaths by suicide using death certification data from the Office for National Statistics. In total they found 2,491 deaths which were recorded as suicide or given an open verdict.

Cancers with poorer prognoses were associated with the highest risk of suicide, the study found.

Patients with mesothelioma had the highest suicide risk at 4.51 times the risk faced by the general population, equating to 4.2 extra deaths per 10,000 person years. This was followed by pancreatic cancer (3.89 times), oesophageal cancer (2.65 times) and lung cancer (2.57 times). 

The overall mortality ratio for suicide among patients with cancer was 1.20.

The report authors concluded: “Despite low absolute numbers, the elevated risk of suicide in patients with certain cancers is a concern, representing potentially preventable deaths. The increased risk in the first six months after diagnosis may indicate an unmet need for psychological support. Our findings suggest a need for improved psychological support for all patients with cancer, and attention to modifiable risk factors, particularly in specific cancer groups.”

While advances in care and treatment meant more people with cancer were surviving and living longer, the study suggested that many were struggling with their diagnosis, highlighting the need for good emotional support including targeted psychological screening, said Dr Jem Rashbass, cancer lead at PHE: “Receiving a cancer diagnosis can be devastating, which is why it’s so important for every patient and their carers to get the support they need. This study shows how critical the first six months are to quality of life and reducing the risk of suicide.”

The reasons for the heightened risk are not fully understood but PHE believes that fear of pain or treatment side-effects may play a part. Dr Rashbass said it underlined the need for staff to be vigilant. “Health professionals play a vital role in offering emotional support to cancer patients at this most difficult time. It is important that they recognise the signs of depression, especially when their patients may often have many other physical needs.”

Andrew Kaye, Head of Policy at Macmillan Cancer Support, said: “Being told you have cancer is like being plunged into the unknown and can be an incredibly difficult and frightening time. That’s why it’s so important that people are given the right support to find their best way through from the moment they’re diagnosed.”

People with cancer should be encouraged to have “difficult conversations” about how they are feeling, he said. “Mental health should be taken just as seriously as physical health when looking at a patient’s holistic needs.”

The results of the study were reported at PHE’s Cancer Services, Data and Outcomes conference in Manchester earlier this week.

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