Temporal trends and characteristics of suicide among women with gynecologic malignancy in the United States
Objective: To examine the trends, characteristics, and outcomes of women with gynecologic malignancies who died of suicide in the United States. Methods: This is a retrospective, observational study using the Surveillance, Epidemiology and End Results program from 1973 to 2013. Women with uterine, o...
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doaj-bc905cb7d8b6450789fce2ca1142697d2020-11-24T21:23:15ZengElsevierGynecologic Oncology Reports2352-57892019-11-0130Temporal trends and characteristics of suicide among women with gynecologic malignancy in the United StatesCaroline J. Violette0Rachel S. Mandelbaum1David J. Nusbaum2Christina J. Duval3Shinya Matsuzaki4Hiroko Machida5Lynda D. Roman6Koji Matsuo7Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, United States; Emory University School of Medicine, Atlanta, GA, United StatesDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, United StatesDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, United StatesDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, United StatesDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, United StatesDepartment of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, JapanDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, United States; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, United StatesDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, United States; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, United States; Corresponding author at: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Norris Comprehensive Cancer Center, 2020 Zonal Avenue, IRD 520, Los Angeles, CA 90033, United States.Objective: To examine the trends, characteristics, and outcomes of women with gynecologic malignancies who died of suicide in the United States. Methods: This is a retrospective, observational study using the Surveillance, Epidemiology and End Results program from 1973 to 2013. Women with uterine, ovarian, and cervical cancers who had cause of death recorded as suicide or self-inflicted injury were included, and temporal trends, patient and tumor characteristics, and outcomes were assessed. Results: Of 467,368 women with gynecologic cancers, there were 309 (0.07%) suicides during the study period. Across the three malignancies, suicide rates significantly decreased during the study period, with uterine cancer exhibiting the highest interval decrease (relative reduction: uterine cancer 88.2%, cervical cancer 78.1%, and ovarian cancer 73.6%; all, P < 0.05). Women with cervical cancer were younger at age of suicide (median age, 50 versus 60–68 years), and women with ovarian cancer had a shorter time to suicide from diagnosis (median time, 27 versus 66–67 months) (both, P < 0.05). On multivariable analysis, white race (hazard ratio [HR] 3.619), Western U.S. residence (HR 2.012), ovarian cancer (HR 1.991), cervical cancer (HR 1.765), stage IV disease (HR 1.735), and divorced status (HR 1.491) remained independent clinico-pathological characteristics associated with increased risk of suicide (all, P < 0.05). Conclusion: This study found that suicide rates in women with gynecologic malignancies have decreased in the United States. Characteristics of suicide vary across cancer types, and certain risk factors of suicide identified in this study may be useful to triage patients at risk for suicidal behavior and inform prevention strategies. Keywords: Suicide, Trend, Characteristics, Cervical cancer, Uterine cancer, Ovarian cancerhttp://www.sciencedirect.com/science/article/pii/S2352578919300992 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Caroline J. Violette Rachel S. Mandelbaum David J. Nusbaum Christina J. Duval Shinya Matsuzaki Hiroko Machida Lynda D. Roman Koji Matsuo |
spellingShingle |
Caroline J. Violette Rachel S. Mandelbaum David J. Nusbaum Christina J. Duval Shinya Matsuzaki Hiroko Machida Lynda D. Roman Koji Matsuo Temporal trends and characteristics of suicide among women with gynecologic malignancy in the United States Gynecologic Oncology Reports |
author_facet |
Caroline J. Violette Rachel S. Mandelbaum David J. Nusbaum Christina J. Duval Shinya Matsuzaki Hiroko Machida Lynda D. Roman Koji Matsuo |
author_sort |
Caroline J. Violette |
title |
Temporal trends and characteristics of suicide among women with gynecologic malignancy in the United States |
title_short |
Temporal trends and characteristics of suicide among women with gynecologic malignancy in the United States |
title_full |
Temporal trends and characteristics of suicide among women with gynecologic malignancy in the United States |
title_fullStr |
Temporal trends and characteristics of suicide among women with gynecologic malignancy in the United States |
title_full_unstemmed |
Temporal trends and characteristics of suicide among women with gynecologic malignancy in the United States |
title_sort |
temporal trends and characteristics of suicide among women with gynecologic malignancy in the united states |
publisher |
Elsevier |
series |
Gynecologic Oncology Reports |
issn |
2352-5789 |
publishDate |
2019-11-01 |
description |
Objective: To examine the trends, characteristics, and outcomes of women with gynecologic malignancies who died of suicide in the United States. Methods: This is a retrospective, observational study using the Surveillance, Epidemiology and End Results program from 1973 to 2013. Women with uterine, ovarian, and cervical cancers who had cause of death recorded as suicide or self-inflicted injury were included, and temporal trends, patient and tumor characteristics, and outcomes were assessed. Results: Of 467,368 women with gynecologic cancers, there were 309 (0.07%) suicides during the study period. Across the three malignancies, suicide rates significantly decreased during the study period, with uterine cancer exhibiting the highest interval decrease (relative reduction: uterine cancer 88.2%, cervical cancer 78.1%, and ovarian cancer 73.6%; all, P < 0.05). Women with cervical cancer were younger at age of suicide (median age, 50 versus 60–68 years), and women with ovarian cancer had a shorter time to suicide from diagnosis (median time, 27 versus 66–67 months) (both, P < 0.05). On multivariable analysis, white race (hazard ratio [HR] 3.619), Western U.S. residence (HR 2.012), ovarian cancer (HR 1.991), cervical cancer (HR 1.765), stage IV disease (HR 1.735), and divorced status (HR 1.491) remained independent clinico-pathological characteristics associated with increased risk of suicide (all, P < 0.05). Conclusion: This study found that suicide rates in women with gynecologic malignancies have decreased in the United States. Characteristics of suicide vary across cancer types, and certain risk factors of suicide identified in this study may be useful to triage patients at risk for suicidal behavior and inform prevention strategies. Keywords: Suicide, Trend, Characteristics, Cervical cancer, Uterine cancer, Ovarian cancer |
url |
http://www.sciencedirect.com/science/article/pii/S2352578919300992 |
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