Suicide in Patients With Cancer: Identifying the Risk Factors

Thoughts of suicide while dealing with cancer are exceedingly common, though relatively few patients make a suicide attempt or complete suicide. Suicide rates among cancer patients are generally thought to be twice as high as that of the general population. However, patients with certain cancer types are at much higher risk for suicide; patients may also be more at risk at certain times during their cancer trajectory. While it is not possible to predict a suicidal act, key features identify those who should be screened more closely. Depression, psychiatric history, previous suicide attempts, hopelessness, demoralization, pain, lack of social support, feeling like a burden to others, and existential concerns (regret, loss of meaning, purpose, and dignity), along with specific demographic characteristics and cancer types confer increased suicidality. Oncologists play a crucial role in identifying these high-risk patients. The Columbia-Suicide Severity Rating Scale is a well-established screening instrument that staff members can use to assess suicidal thinking in patients.