Suicide attempts in patients with head and neck cancer in Taiwan

Objective: We examined the risk of suicide attempts in patients with head and neck cancer (HNC) in comparison with that in the general population and in patients of other cancers (including all other cancers rather than HNC). Methods: The definition of suicide attempt here is that an attempt of suicide with or without completed suicide. This retrospective cohort study consisted of 66 931 cases of HNC and individual without HNC from the general population assigned to the control group. Cox's proportion hazard regression analysis was conducted to compare the subsequent suicide attempt risk between patients with HNC and the control group. Results: The suicide attempt rate for HNC and control groups were 7.44 and 1.98 per 10 000 person-year, respectively. A more than three-fold higher risk of suicide attempts was observed in the HNC group than in the control group (adjusted hazard ratio [HR]: 3.72; 95% confidence intervals: 2.85, 4.88). Patients of HNC also had a significantly 1.9-fold higher risk of suicide attempt than patients with other cancers. Subsequent stratified analyses revealed a significantly elevated risk of suicide attempts across every cancer anatomic subsite and almost all categories of various demographics, but the risk was limited to male patients and patients with no comorbidity. The suicide attempt rate was the highest among patients with oropharyngeal cancer, and chemotherapy was associated with an elevated risk of suicide attempt. Conclusions: Patients with HNC are vulnerable to an increased risk of suicide attempts than the general population and patients with other cancers.