Cancer's Toll Raises Suicide Risk for Spouses
Hello. I'm Dr Maurie Markman from City of Hope. I'd like to briefly discuss a very difficult topic, but one that I believe needs to be more openly discussed — not necessarily the specifics of the topic, but the implications of findings.
The paper I'm referring to is entitled, 'Suicide attempt and suicide death among spouses of patients with cancer.' This was reported in JAMA Oncology .
What we're looking at here in this analysis are data from Denmark. There are a number of countries, particularly in Scandinavia, that have a national registry of diseases, treatments, and outcomes. We are relying here on data from Denmark, but I would have no reason to believe it's any different than what we might see in the United States.
We're looking at registry data from 1986 to 2016. The analysis was performed in August 2022. Again, what they were looking at here is the risk of suicide attempts among spouses of individuals with cancer.
Clearly, we were looking at registries that relate to cancer, and then they would also have other registries related to attempted suicide or actual suicide deaths, a nd they were matching these databases. It's obviously complex registry data, which of course, we would not have in the United States, but it's potentially very relevant.
T he term they used was exposed individuals, these were the spouses of individuals with cancer. There were 409,000 individuals, and they compared that to over 2 million individuals who would be unexposed. These must be individuals in the population, presumably age matched, without cancer.
They saw that the risk of a suicide attempt among spouses of patients with cancer was much higher than the population without cancer,particularly notable in the first year after diagnosis. The hazard ratio of those at risk versus not at risk for a suicide attempt was 1.45, and 2.56 for suicide death for the exposed compared to the unexposed, two-and-a-half-time risk.
It's noted in the paper that there was even a higher risk — and I think the numbers will get smaller here — if that family member was diagnosed with an advanced-stage cancer or if the individual died of cancer. This is not surprising.
Clearly there's much to be discussed here, but the most important point to be made is the stress — both psychological and financial, fear, risk of depression (particularly in an individual who might already have some concerns) — is very real, and this paper makes it very palpable.
As emphasized in the paper, b ehavioral support, social work support, and financial support over time, particularly at the beginning of the cancer journey, is really important. What we can do as individuals, as family, as friends, but also as a healthcare establishment, either at an individual physician level or at a public health level, to help families and to help spouses through this journey is critical to potentially avoidsuicide and certainly suicide deaths.
This is a very complex subject and a very personal subject for many individuals but a very important one. Thank you for your attention.
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