ImportanceLittle is known about the risk of suicidal behavior in relation to having a spouse with a cancer diagnosis.ObjectiveTo estimate the risk of suicide attempt and suicide death among spouses of patients with cancer.Design, Setting, and ParticipantsThis nationwide cohort study in Denmark collected registry-based data from 1986 through 2016. Analyses were performed from August 8, 2022, to October 30, 2023. Individuals who had a spouse with a cancer diagnosed during 1986 to 2015 were compared with individuals whose spouse did not have a cancer diagnosis during the same period, randomly selected from the general population and matched by birth year and sex.ExposureHaving a spouse with a cancer diagnosis.Main Outcomes and MeasuresSuicide attempt was identified through the Danish National Patient Register and the Danish Psychiatric Central Research Register, whereas suicide death was identified through the Danish Causes of Death Register, through 2016. Flexible parametric and Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs for suicide attempt and suicide death among spouses of patients with a cancer diagnosis.ResultsThe study included 409 338 exposed individuals and 2 046 682 unexposed individuals (median [IQR] age at cohort entry for both groups, 63 [54-70] years; 55.4% women). During the follow-up, 2714 incident cases of suicide attempt among exposed individuals (incidence rate [IR], 62.6 per 100 000 person-years) and 9994 among unexposed individuals (IR, 50.5 per 100 000 person-years) were identified, as well as 711 cases of suicide death among the exposed individuals (IR, 16.3 per 100 000 person-years) and 2270 among the unexposed individuals (IR, 11.4 per 100 000 person-years). An increased risk of suicide attempt (HR, 1.28; 95% CI, 1.23-1.34) and suicide death (HR, 1.47; 95% CI, 1.35-1.60) was observed among spouses of patients with cancer throughout the follow-up. The increased risk was particularly notable during the first year after the cancer diagnosis, with an HR of 1.45 (95% CI, 1.27-1.66) for suicide attempt and 2.56 (95% CI, 2.03-3.22) for suicide death. There was a greater risk increase for both suicide attempt and suicide death when the cancer was diagnosed at an advanced stage or when the spouse died after the cancer diagnosis.Conclusions and RelevanceThese findings suggest a need for clinical and societal awareness to prevent suicidal behaviors among spouses of patients with cancer, particularly during the first year following the cancer diagnosis.

中文翻译：

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癌症患者配偶的自杀未遂和自杀死亡


重要性对于配偶被诊断出癌症的自杀行为风险知之甚少。目的估计癌症患者配偶自杀未遂和自杀死亡的风险。设计、设置和参与者这项在丹麦进行的全国性队列研究收集了 1986 年至 2016 年基于登记的数据。分析于 2022 年 8 月 8 日至 2023 年 10 月 30 日进行。将 1986 年至 2015 年期间配偶被诊断出患有癌症的个体与配偶在同一时期未被诊断出癌症的个体进行比较，从一般人群中随机选择并按出生年份和性别进行匹配。暴露配偶被诊断出患有癌症。主要结局和措施自杀未遂是通过丹麦国家患者登记册和丹麦精神病学中央研究登记册确定的，而自杀死亡是通过丹麦死因登记册确定的，直到 2016 年。使用灵活的参数和 Cox 比例风险模型来估计癌症诊断患者配偶自杀未遂和 95% CI 的风险比 （HRs） 和 95% CIs。结果该研究包括 409 338 名暴露个体和 2 046 682 名未暴露个体（两组入组时的中位 [IQR] 年龄为 63 [54-70] 岁;55.4% 为女性）。在随访期间，确定了 2714 例暴露个体自杀未遂事件（发病率 [IR]，每 100 000 人年 62.6 例）和未暴露个体中的 9994 例（IR，每 100 000 人年 50.5 例），以及暴露个体中 711 例自杀死亡病例（IR，每 100 000 人年 16.3 例）和未暴露个体中的 2270 例自杀死亡病例（IR， 每 100 000 人年 11.4 例）。自杀未遂风险增加 （HR， 1.28;在整个随访过程中，癌症患者的配偶中观察到 95% CI，1.23-1.34）和自杀死亡 （HR，1.47;95% CI，1.35-1.60）。在癌症诊断后的第一年，风险增加尤为明显，自杀未遂的 HR 为 1.45 （95% CI，1.27-1.66），自杀死亡的 HR 为 2.56 （95% CI，2.03-3.22）。当癌症在晚期被诊断出或配偶在癌症诊断后死亡时，自杀未遂和自杀死亡的风险增加更大。结论和相关性这些发现表明需要临床和社会意识来防止癌症患者配偶的自杀行为，尤其是在癌症诊断后的第一年。