Analysis of the risk of suicide and accidental death in patients with pancreatic cancer in the past 40 years

Purpose: Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) 18-registry Custom database (1975-2016) to determine the latest risk and risk factors of suicide/accidental death in pancreatic cancer patients. Methods: SEER*Stat was used to get the Standardized Mortality Ratio (SMR) for suicide/accidental death in pancreatic cancer patients. The Adjusted Risk Ratio (ARR) and risk factors for suicide/accidental death in pancreatic cancer patients were achieved by the multivariate Poisson regression model and multivariate Cox regression model. Results: Pancreatic cancer patients diagnosed within three months have the highest SMR of suicide (8.52, 95% Confidence Interval [CI]: 5.71-12.24) and accidental death (2.75, 95% CI: 1.98-3.72); Among the pancreatic cancer patients hadn’t performed surgery, patients classified as ‘Recommended but not performed’ have a higher ARR of suicide(3.35, 95% CI: 2.22-4.87) and accidental death(2.12, 95% CI: 1.53-2.87) than patients classified as ‘Not recommended’, the same trend also showed in the multivariate Cox regression model: The Hazard Ratio (HR) of ‘Recommended but not performed’ patients for suicide(Vs ‘Performed’, 2.68, 95% CI: 1.36-5.30) and accidental death(Vs ‘Performed’, 2.68, 95% CI: 1.36-5.30) higher than ‘Not recommended’ patients. Conclusion: Pancreatic cancer patients have a significantly higher risk of suicide and accidental death than the general population and other cancer patients, especially within three months of diagnosis. In addition, we found in the pancreatic cancer patients who hadn’t performed surgery, those ‘Recommended but not performed’ have a higher risk of suicide and accidental death than those ‘Not recommended’. Therefore, we suggest Department doctors collaborate with oncology psychologists and maintain regular touch with patients who are ‘Recommended but not performed’ and diagnosed within three months.