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Suicide and cardiovascular death after a cancer diagnosis
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Örebro universitet, Institutionen för hälsovetenskap och medicin. Clinical Epidemiology and Biostatistics Unit, Örebro University Hospital, Örebro, Sweden; Department of Epidemiology, Harvard School of Public Health, Boston, USA; Center of Public Health Sciences, University of Iceland, Reykjavík, Iceland.ORCID-id: 0000-0002-3649-2639
Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA; Department of Epidemiology, Harvard School of Public Health, Boston, USA.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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2012 (Engelska)Ingår i: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 366, nr 14, s. 1310-1318Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Receiving a diagnosis of cancer is a traumatic experience that may trigger immediate adverse health consequences beyond the effects of the disease or treatment.

Methods: Using Poisson and negative binomial regression models, we conducted a historical cohort study involving 6,073,240 Swedes to examine the associations between a cancer diagnosis and the immediate risk of suicide or death from cardiovascular causes from 1991 through 2006. To adjust for unmeasured confounders, we also performed a nested, self-matched case-crossover analysis among all patients with cancer who died from suicide or cardiovascular diseases in the cohort.

Results: As compared with cancer-free persons, the relative risk of suicide among patients receiving a cancer diagnosis was 12.6 (95% confidence interval [CI], 8.6 to 17.8) during the first week (29 patients; incidence rate, 2.50 per 1000 person-years) and 3.1 (95% CI, 2.7 to 3.5) during the first year (260 patients; incidence rate, 0.60 per 1000 person-years). The relative risk of cardiovascular death after diagnosis was 5.6 (95% CI, 5.2 to 5.9) during the first week (1318 patients; incidence rate, 116.80 per 1000 person-years) and 3.3 (95% CI, 3.1 to 3.4) during the first 4 weeks (2641 patients; incidence rate, 65.81 per 1000 person-years). The risk elevations decreased rapidly during the first year after diagnosis. Increased risk was particularly prominent for cancers with a poor prognosis. The case-crossover analysis largely confirmed results from the main analysis.

Conclusions: In this large cohort study, patients who had recently received a cancer diagnosis had increased risks of both suicide and death from cardiovascular causes, as compared with cancer-free persons. (Funded by the Swedish Council for Working Life and Social Research and others.).

Ort, förlag, år, upplaga, sidor
Walton, USA: Massachusetts Medical Society , 2012. Vol. 366, nr 14, s. 1310-1318
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Medicin och hälsovetenskap Cancer och onkologi
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Medicin
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URN: urn:nbn:se:oru:diva-24620DOI: 10.1056/NEJMoa1110307ISI: 000302343000008PubMedID: 22475594Scopus ID: 2-s2.0-84859393599OAI: oai:DiVA.org:oru-24620DiVA, id: diva2:545851
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärdVetenskapsrådetHjärnfondenTillgänglig från: 2012-08-21 Skapad: 2012-08-21 Senast uppdaterad: 2018-09-18Bibliografiskt granskad

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