在全世界,肝细胞癌(HCC)仍然是肝癌的主要类型。肝癌患者的自杀风险高于普通人群。因此,这项研究的目的是确认自杀率,标准化死亡率(SMR),以及与HCC患者自杀相关的潜在危险因素。
从监测中收集HCC患者,流行病学,和1975-2016年的最终结果(SEER)数据库。计算了这些患者的自杀率和SMR,和1975-2016年美国(U.S.)的一般人口被用作参考.采用单变量和多变量Cox回归分析肝癌患者自杀的危险因素。
在102,567例HCC患者中发现70例自杀,观察时间为160,500.88人年。自杀率为每10万人年43.61,SMR为2.26(95%CI:1.78-2.84)。关于Cox回归,诊断年份(1975-1988年vs.2003-2016年,HR:3.00,95%CI:1.01-8.89,P=0.047;1989-2002年vs.2003-2016年,HR:1.92,95%CI:1.10-3.34,P=0.021),性别(男性vs.女性,HR:8.72,95%CI:2.73-27.81,P<0.001),诊断年龄(63-105岁与0-55岁,HR:2.28,95%CI:1.21-4.31,P=0.011),种族(白色种族与美洲印第安人/阿拉斯加原住民,亚洲/太平洋岛民,HR:3.02,95%CI:1.35~6.76,P=0.007)是HCC患者自杀的独立危险因素。
在早期(1975-2002年)被诊断,男性,年龄较大(63-105岁),白人种族,肝癌患者的生存月(<2个月)与自杀显著相关.为了防止自杀行为,政府,临床医生,家庭成员应采取适当措施降低自杀率,尤其是有自杀高危因素的患者。
Throughout the world, hepatocellular carcinoma (HCC) remains the primary type of liver cancer. The suicide risk was higher among patients with HCC than the general population. Hence, the purpose of this study was to confirm the suicide rates, standardized mortality ratios (SMRs), and the potential risk factors associated with suicide among HCC patients.
HCC patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database during 1975-2016. Suicide rates and SMRs among these patients were calculated, and the general population of the United States (U.S.) during 1975-2016 was used as a reference. Univariable and multivariable Cox regression were taken to find out the underlying risk factors of suicide in HCC patients.
There were 70 suicides identified among 102,567 individuals with HCC observed for 160,500.88 person years. The suicide rate was 43.61 per 100,000 person-years, and SMR was 2.26 (95% CI: 1.78-2.84). On Cox regression, year of diagnosis (1975-1988 vs. 2003-2016, HR: 3.00, 95% CI: 1.01-8.89, P = 0.047; 1989-2002 vs. 2003-2016, HR: 1.92, 95% CI: 1.10-3.34, P = 0.021), gender (male vs. female, HR: 8.72, 95% CI: 2.73-27.81, P < 0.001), age at diagnosis (63-105 years old vs. 0-55 years old, HR: 2.28, 95% CI: 1.21-4.31, P = 0.011), race (white race vs. American Indian/Alaska Native, Asian/Pacific Islander, HR: 3.02, 95% CI: 1.35-6.76, P = 0.007) were independent risk factors of suicide among HCC patients.
Diagnosed in the early years (1975-2002), male sex, the older age (63-105 years old), white race, survival months (<2 months) were significantly associated with suicide among HCC patients. For the sake of preventing suicide behaviors, the government, clinicians, and family members should take adequate measures to decrease the rate of suicide, especially in patients with high-risk factors of suicide.