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Prostate Cancer

A Significant Risk Factor for Late-Life Suicide

Received November 19, 2002; revised June 2, 2003; accepted June 6, 2003. From the Miami Veterans Affairs Medical Center (MDL,EJO), the University of Miami School of Medicine, Dept. of Psychiatry (MDL,EJO), the Atlanta Veterans Affairs Medical Center (MB), the Durham Veterans Affairs Medical Center (HBB,SCG,RDH), the Duke University Medical Center (HBB,SCG,RDH), and the Orlando Regional Medical Center (AG). Send correspondence and reprint requests to Maria D. Llorente, M.D., 1601 NW 12 Ave. #116A, Miami, FL 33125. e-mail: Maria.Llorente{at}med.va.gov
© 2005 American Association for Geriatric Psychiatry

Objective: The authors sought to determine the incidence of suicide and its relevant correlates among men with prostate cancer. Methods: This was a population-based, retrospective cohort review of men age 65 and older, residing in South Florida between 1983 and 1993. Average annual suicide rate was calculated for prostate cancer-related suicides and contrasted with age and gender-specific rates in the same geographic area. Results: Of 667 completed suicides, 20 were prostate cancer-related (3% of the total male suicide sample). The average annual incidence of suicide for men was 55.32 per 100,000 persons, but for men with prostate cancer, the rate was 274.7 per 100,000. The risk of suicide in men with prostate cancer was 4.24 times that of an age- and gender-specific cohort. The clinical correlates included depression (70%), cancer diagnosis within 6 months of suicide (80%), physician visit within 1 month of suicide (60%), and being foreign-born (70%). Conclusion: The incidence of suicide among older men with prostate cancer is higher than previously recognized. Depression, recent diagnosis, pain, and being foreign-born are important clinical correlates. Screens for depression and suicide in older men with prostate cancer should be done after diagnosis and redone during the first 6 months regularly, particularly in the primary-care setting. Public education is needed to decrease the stigma associated with having a cancer diagnosis.

Key Words: Depression • Cancer • Suicide

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