Using suicide notes to understand suicide among cancer patients: A mixed-method study

Area of Science:

• Psychiatry
• Oncology
• Forensic Science

Background:

• Cancer patients face elevated suicide risks.
• Previous research has not analyzed suicide notes from cancer patients to understand their expressed reasons for suicide.
• This study aims to fill this gap by examining suicide notes.

Purpose of the Study:

• To compare characteristics of cancer suicide cases who left notes versus those who did not.
• To identify patterns in expressed reasons for suicide among cancer patients using their suicide notes.

Main Methods:

• Analysis of suicide cases (2012-2017) from Hong Kong Coroner's Court reports.
• Bivariate tests and logistic regression to compare characteristics of note-leavers and non-note-leavers among cancer suicide cases.
• Thematic analysis of suicide notes to identify expressed reasons for suicide, stratified by cancer status and age.

Main Results:

• Cancer suicide note-leavers were younger, more likely male, used non-violent methods, had better housing, and lived alone compared to non-leavers.
• Physical disease suffering was the primary theme in suicide notes from cancer patients across all age groups.
• Non-cancer suicide note-leavers showed varied themes, with physical illness being dominant in the elderly.

Conclusions:

• Cancer suicide note-leavers exhibit distinct characteristics, with physical illness being a key expressed reason.
• Healthcare providers must address both mental and physical needs of cancer patients.
• Enhancing quality of life and patient autonomy are crucial for suicide prevention in cancer patients.