We identified PCa survivors from the Surveillance, Epidemiology, and End Results (SEER) program from January 1975 to December 2019. Standardized mortality rate (SMR) was calculated d to assess the relative risk of suicide in PCa survivors compared with the general men population. Poisson regression model was performed to test for trend of SMRs. The cumulative mortality rate of suicide was calculated to assess the clinical burden of suicide mortality.
7108 (0.2%) cases were death from suicide cause, and 2,308,923(65.04%%) cases recorded as dying from non-suicidal causes. Overall, a slightly higher suicide mortality rate among PCa survivors was observed compared with general male population (SMR: 1.15, 95%CI: 1.09-1.2). The suicide mortality rate declined significantly relative to the general population by the calendar year of diagnosis, from an SMR of 1.74(95%CI: 1.17-2.51) in 1975-1979 to 0.99(0.89-1.1) in 2015-2019 (Ptrend < 0.001). PCa survivors with aged over 84 years, black and other races, registered in registrations (including Utah, New Mexico, and Hawaii) failed to observe a decrease in suicide mortality (Ptrend > 0.05). The cumulative suicide mortality during 1975-1994 was distinctly higher than in 1995-2019(P < 0.001).
The trend in suicide mortality declined significantly from 1975 to 2019 among PCa survivors compared with the general male population in the United States. Notably, part of PCa survivors had no improvement in suicide mortality, and additional studies in the future were needed to explore it.
方法:我们从监测中确定了PCa幸存者,流行病学,以及1975年1月至2019年12月的最终结果(SEER)计划。计算标准化死亡率(SMR)以评估PCa幸存者与普通男性人群相比的自杀相对风险。采用泊松回归模型对SMR的变化趋势进行检验。计算自杀的累积死亡率以评估自杀死亡率的临床负担。
结果:7108例(0.2%)是自杀死亡,2,308,923例(65.04%)被记录为死于非自杀原因。总的来说,与一般男性人群相比,PCa幸存者的自杀死亡率略高(SMR:1.15,95CI:1.09~1.2).到诊断的日历年,自杀死亡率相对于普通人群显着下降,从1975-1979年的1.74(95CI:1.17-2.51)的SMR到2015-2019年的0.99(0.89-1.1)(Ptrend<0.001)。年龄超过84岁的PCa幸存者,黑人和其他种族,在注册中注册(包括犹他州,新墨西哥州,和夏威夷)未能观察到自杀死亡率的下降(P趋势>0.05)。1975-1994年的累计自杀死亡率明显高于1995-2019年(P<0.001)。
结论:与美国普通男性人群相比,从1975年到2019年,PCa幸存者的自杀死亡率趋势显着下降。值得注意的是,部分PCa幸存者的自杀死亡率没有改善,未来还需要更多的研究来探索它。