Suicide and CV Death Increase After Diagnosis of Cancer Reply

The risk of suicide and cardiovascular death rises sharply after cancer is diagnosed, according to a new study from Sweden published in the New England Journal of Medicine. Fang Fang and colleagues analyzed data from more than 6 million Swedes, including more than half a million who received a first diagnosis of cancer.

Following a sharp initial increase in suicide and CV death, risk rapidly declined thereafter, but remained elevated during followup. The increased risk in suicide and CV death was greatest among people with highly fatal cancers. A second, case-crossover analysis confirmed the broad findings of the nationwide cohort study.

Here are the main results of the cohort study:

Relative risk (RR) compared with cancer-free people and incidence of suicide after cancer diagnosis:

  • First week: RR 12.6 (CI 8.6-17.8); incidence rate: 2.50 per 1000 person-years)
  • First year: RR 3.1 (2.7-3.5); incidence rate: 0.60 per 1000 person-years

Relative risk (RR) compared with cancer-free people and incidence of cardiovascular death after cancer diagnosis:

  • First week: RR 5.6 (CI 5.2-5.9); incidence rate: 116.80 per 1000 person-years)
  • First 4 weeks: RR 3.3 (3.1-3.4); incidence rate: 65.81 per 1000 person-years

The authors concluded that their “findings suggest that a cancer diagnosis constitutes a major stressor, one that immediately affects the risk of critical, fatal outcomes. We speculate that our findings show only a portion of the range of effects induced by the emotional distress associated with a cancer diagnosis.”

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