New research from the Medical College of Georgia at Georgia Regents University (GA, USA) concludes that older, single white males with advanced bladder cancer are at highest risk of suicide when compared with other comparable individuals with genitourinary cancers.
The study, recently published in the journal Cancer, is one of the first assessments of the risk of suicide in this demographic. Genitourinary cancers comprise almost 25% of all new cancer diagnoses in the USA.
“The older, white, single male is already at higher risk in the general society for suicide; add on the fact that he has advanced bladder cancer, and this is a high-risk patient,” explained Zachary Klaassen (Georgia Regents University), corresponding author of the research. The review identified the previously described patients’ suicide as a public health dilemma, which warrants physician vigilance.
The rigorous treatment and recovery schedule for aggressive bladder cancer is well documented, with close follow-up for signs of metastasis. However, if caught early enough, bladder cancer is very curable.
The scientists analyzed data from the National Cancer Institute’s SEER database from 1988–2010 and found 1.2 million individuals diagnosed with genitourinary cancer. Variables such as age, sex, race, as well as disease and treatment aggressiveness were also examined. It was discovered that patients with bladder cancer, regardless of surgery or aggressiveness, were at higher risk of suicide than any other genitourinary cancer patients.
Further analysis demonstrated that older people with bladder, prostate or testicular cancer had a general increase in suicide risk. When analyzing the black population specifically, individuals with bladder cancer were at increased risk of suicide, however black individuals with bladder, prostate and kidney cancer had lower suicide rates than white people within the same parameters. It was demonstrated that prostate cancer patients had an increased suicide risk over time, with the highest rate 15 years or longer after initial diagnosis.
In an accompanying editorial, it was also noted that increased age is associated with suicide in general, as well as in cancer patients.
Statistics from the American Cancer Society show the average age of bladder cancer diagnosis is 73 years and approximately 90% of bladder cancer patients are over 55 years. There are approximately 74,000 new cases of bladder cancer recorded in the USA each year, with males and smokers at increased risk.
According to Centers for Disease Control and Prevention figures, suicide is the tenth most common cause of death, while cancer is the second most common. Suicide rates in the general population are experiencing an upward trend, with the estimated current rate at 13 deaths per 100,000 individuals annually. The data in the research demonstrate that bladder cancer patients’ overall suicide risk was 2.7 times higher.
In further investigations the researchers want to reanalyze these patient groups, investigating any signs of prior psychiatric issues and the effect of any treatments, such as antidepressants, which may influence their conclusions.