TY  - JOUR
PY  - 2015//
TI  - Factors associated with suicide in patients with genitourinary malignancies
JO  - Cancer
A1  - Klaassen, Zachary
A1  - Jen, Rita P.
A1  - DiBianco, John M.
A1  - Reinstatler, Lael
A1  - Li, Qiang
A1  - Madi, Rabii
A1  - Lewis, Ronald W.
A1  - Smith, Arthur M.
A1  - Neal, Durwood E.
A1  - Moses, Kelvin A.
A1  - Terris, Martha K.
SP  - 1864
EP  - 1872
VL  - 121
IS  - 11
N2  - BACKGROUND: Approximately 70% of all suicides in patients aged >60 years are attributed to physical illness, with higher rates noted in patients with cancer. The purpose of the current study was to characterize suicide rates among patients with genitourinary cancers and identify factors associated with suicide in this specific cohort. <br><br>METHODS: Patients with prostate, bladder, kidney, testis, and penile cancer were identified in the Surveillance, Epidemiology, and End Results database (1988-2010). Standardized mortality ratios (SMRs) and 95% confidence intervals (95% CIs) were calculated for each anatomic site. Multivariable logistic regression models generated odds ratios (ORs) for the identification of factors associated with suicide for each malignancy. <br><br>RESULTS: There were 2268 suicides identified among 1,239,522 individuals with genitourinary malignancies observed for 7,307,377 person-years. The SMRs for patients with cancer were 1.37 for prostate cancer (95% CI, 0.99-1.86), 2.71 for bladder cancer (95% CI, 2.02-3.62), 1.86 for kidney cancer (95% CI, 1.32-2.62), 1.23 for testis cancer (95% CI, 0.88-1.73), and 0.95 for penile cancer (95% CI, 0.65-1.35). On multivariable analysis, male sex was found to be associated with odds of suicide among patients with bladder cancer (OR, 6.63) and kidney cancer (OR, 4.98). Increasing age was associated with suicide for patients with prostate, bladder, and testis cancer (OR range, 1.03-1.06). Distant disease was associated with suicide in patients with prostate, bladder, and kidney cancer (OR range, 2.82-5.43). Among patients with prostate, bladder, and kidney cancer, African American patients were less likely to commit suicide compared with white individuals (OR range, 0.26-0.46). <br><br>CONCLUSIONS: Suicide in patients with genitourinary malignancies poses a public health dilemma, especially among men, the elderly, and those with aggressive disease. Clinicians should be aware of risk factors for suicide in these patients. Cancer 2015. © 2015 American Cancer Society.<p />  <p>Language: en</p>
LA  - en
SN  - 0008-543X
UR  - http://dx.doi.org/10.1002/cncr.29274
ID  - ref1
ER  -