Suicide rates and methods among veteran cancer survivors within the Veterans Health Administration (VHA), 2010-2020

Suicide rates among Veterans without mental health conditions have risen 16 % between 2001 and 2022; cancer may be one factor contributing to this increased risk. The current study aimed to provide more comprehensive understanding of suicide risk among Veteran cancer survivors. Suicide rates were calculated for Veterans diagnosed and treated for cancer through the Veterans Health Administration (VHA) between 2010 and 2020 (n = 439,667), then compared to rates among an age and sex frequency matched cohort without cancer. Age, time period, and cancer-related factor stratified suicide rates and suicide methods were examined. Overall, suicide rates in Veterans with cancer were 37 % higher than Veterans with no history of cancer. Age-specific suicide rates differed by between Veterans with and without a history of cancer; rates were highest for cancer survivors 85+ years (70.97/100,000) and for those 18-54 years in the non-cancer cohort (46.63/100,000). The hazard rate of suicide was 86 % higher for Veterans with cancer in the first year after diagnosis than for Veterans without cancer. Suicide rates were particularly elevated among those with a history of esophageal and pancreatic cancer, and for those in early survivorship (<3 years since last treatment). Firearms were a more prevalent suicide method among cancer survivors (79.37 %) than among those with no history of cancer (72.30 %); this was especially true among cancer survivors 70-84 years of age, 89.9 % of whom used a firearm. These findings support the importance of suicide risk screening and assessment among Veteran cancer survivors and potential avenues for prevention, such as firearm lethal means safety.