Suicide Rates Among Patients Receiving Palliative Care-Descriptive Results of a National Cohort Study

Background/Objectives: One of the most relevant risk factors for suicide is the terminal stage of oncological disease. However, it remains unclear whether palliative care affects suicide rates in this population. This study aimed to compare suicide rates in oncological patients receiving palliative care to a general oncological cohort. Methods: The rate of suicide among all patients admitted to the palliative care ward at the Medical University of Vienna for oncological diagnoses from November 2012 to March 2022 was compared to that of a diagnosis-matched control group retrieved from the Austrian Cancer Registry. Competing risk models in SAS (SAS Institute Inc., Cary, NC, USA) were used to test for significant differences in cumulative incidences of death by suicide. Cumulative incidences were also compared for sex and the most common diagnostic groups separately. Results: 1524 patients with oncological diagnoses receiving palliative care and 794,986 patients in the control group were included in the analysis. No excess suicide mortality was revealed (p = 0.117) in the group of patients receiving palliative care. Importantly, this remained true, after also including any potential cases of suicide within the palliative care sample in the analysis (p = 0.467). Only for patients with pancreatic cancer, a higher cumulative suicide incidence in the palliative care sample was found (p = 0.008). Conclusions: Palliative care for oncological patients may be able to alleviate the excess suicide mortality that is otherwise expected in terminally ill patients. This study underscores the importance of comprehensive multidisciplinary end-of-life care that addresses not only physical but also psychosocial aspects.