Document Type

Conference Proceeding

Publication Date


Publication Title

Ann Oncol


Background: A cancer diagnosis results in significant distress and adverse psychosocial sequelae, including suicide, the 10th leading cause of death in the United States. Primary risks for death by suicide include depression, and opioid abuse, which are prevalent amongst cancer survivors. Yet, it remains unclear whether they are also associated with other suicidal outcomes, such as ideation, planning, and suicidal attempt. This study examined associations between suicide-related outcomes, depression and non-medical use of pain prescriptions among cancer survivors in the United States.

Methods: We used cross-sectional data from the National Survey on Drug Use and Health (NSDUH; 2015-2019), a nationwide study in the United States that provides data on mental health and other health concerns. Outcomes of interest were patient-reported suicidal ideation, suicidal planning, and suicidal attempt. Participants were grouped as: individuals with a history of cancer, individuals without a history of cancer, but with fair/poor health, and individuals without a history of cancer but with excellent/very good/good health.

Results: Weighted logistic regression analyses that adjusted for sociodemographics and substance use showed associations between a history of cancer and suicidal ideation (aOR = 1.32, 95% CI 1.10, 1.58). Among individuals with a history of cancer, depression and non-medical use of pain prescriptions were consistently associated with suicidal ideation (aORdepression = 7.37, 95% CI 4.52, 12.03; aORpain prescriptions = 3.36, 95% CI 1.27, 8.91, planning (aORdepression = 10.31, 95% CI 5.79, 18.34; and aORpain prescriptions = 3.77, 95% CI 1.20, 11.85), and attempt (aORdepression = 4.29, 95% CI 1.41, 13.06).

Conclusions: Individuals with a history of cancer are at increased odds of adverse suicidal outcomes, driven by depression and non-medical pain prescription. Routinely assessing for depression and non-medical use of pain prescriptions may be a crucial suicide prevention strategy in oncology.



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