Cancer and the risk of suicide in older Americans

To determine whether the risk of suicide is greater among patients with cancer than among patients with other medical illnesses.

A case-control study of the suicide risk associated with medical illness among older Americans that used healthcare utilization data linked to prescription and mortality files. The patient population was comprised of 1,408 New Jersey residents age 65 years or older who were enrolled in Medicare and in a pharmaceutical insurance program. Patient cases (n = 128) died as a result of suicide during the study period of 1994 to 2002. Control patients (n = 1,280) were frequency-matched to patient cases on age and sex. Data were analyzed by using the odds ratio (OR) of suicide adjusted for age, sex, ethnicity, medical and psychiatric comorbidity, and use of prescription medications.

In adjusted analyses, the only medical condition that remained associated with suicide was cancer (OR, 2.3; 95% CI, 1.1 to 4.8). Suicide also remained associated with a diagnosis of affective disorder (OR, 2.3; 95% CI, 1.3 to 4.2), anxiety/personality disorder (OR, 2.2; 95% CI, 1.3 to 3.6), treatment with antidepressants (OR, 2.0; 95% CI, 1.2 to 3.2), and treatment with opioid analgesics (OR, 1.6; 95% CI, 1.0 to 2.5).

The risk of suicide in older adults is higher among patients with cancer than among patients with other medical illnesses, even after psychiatric illness and the risk of dying within a year were accounted for.