Suicide risk among urinary bladder cancer patients compared with the standard population: a nationwide study in Sweden
DOI:
https://doi.org/10.2340/sju.v60.44784Keywords:
Urinary bladder cancer, urothelial cancer, suicide risk, risk factorsAbstract
Objective: To assess the risk of suicide after a diagnosis of urinary bladder cancer (UBC) compared with the standard population and to identify potential risk factors and time dependence associated with suicide in patients with UBC.
Method: We used data from the Bladder Cancer Data Base Sweden 2.0 (BladderBaSe), including all individuals aged 18 years or older, diagnosed with UBC between 1997 and 2019. Suicides were identified using ICD-10 codes X60-X84. We compared the number of suicides identified in BladderBaSe with the expected number in a Swedish standard population of the same age and sex distribution during the same period.
Outcome measurements: The risk of suicide was determined using standardized mortality ratios (SMR) with 95% confidence intervals (CI).
Results: Among 53,298 patients with UBC included in our study, 106 suicides were identified compared with an expected 66 in the standard population (SMR: 1.6; 95% CI: 1.31–1.93). The risk of suicide was highest within the first 4 weeks after diagnosis (SMR: 4.66; 95% CI: 2.48–7.97), in patients with advanced UBC (SMR: 5.64; 95% CI: 2.06–12.3), those receiving palliative treatment (SMR: 5.03; 95% CI: 2.51–9.01), and those living alone (SMR: 2.87; 95% CI: 2.22 - 3.66).
Conclusion: The suicide risk among UBC patients is significantly elevated and shaped by multiple factors, with the highest risk observed in the first 4 weeks from diagnosis. Healthcare providers should maintain heightened vigilance for suicidal ideation, particularly during the critical period immediately following diagnosis, to ensure timely support and intervention.
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Copyright (c) 2025 Lewar Hawez, Oskar Bergengren, Mats Ahlberg, Hans Garmo, Mieke Van Hemelrijck, Ulla-Karin Nyberg, Truls Gardmark, Lars Holmberg, Fredrik Liedberg, Anna Bill-Axelson
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