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低收入和农村地区患有癌症和癌症幸存者的人面临更大的自杀风险

一名悲伤的癌症妇女的照片看着窗外。
与居住在高收入和城市地区的人相比,被诊断出患有低收入和农村地区的癌症患者面临自杀的风险。(盖蒂图像照片)
Ryan Suk, PhD, MS. (Photo by UTHealth Houston)
Ryan Suk, PhD, MS. (Photo by UTHealth Houston)

癌症对任何人来说都是不受欢迎的打击,但是与居住在高收入和城市地区的人相比,被诊断出在低收入和农村地区的癌症的人面临自杀的风险增加。休斯敦的科学中心(休斯顿乌西卫生).

The research, which focused on determining if the risks and patterns of suicide deaths differed by area-level income and rural residency among those with a cancer diagnosis, was recently published inJAMA Network Open.

“接受癌症诊断的人面临许多挑战,例如获得可靠且负担得起的护理,这可能会增加与患病有关的现有焦虑或抑郁症。”管理,政策和社区卫生部门UTHealth公共卫生学院. “But those who live in economically or medically underserved areas can be especially affected.”

研究团队beplay苹果手机能用吗使用2000年至2016年之间从监视,流行病学和最终结果(SEER)计划收集的数据,National Cancer Institute, noted that of the 5,362,782 people who had cancer diagnosis in 635 counties across the United States, 6,357 died of suicide. Most study participants were men (51.2%), white (72.2%), and almost half (49.7%) were older than 65.

为了将自杀风险与整个美国人口进行比较,研究人员使用了来自beplay苹果手机能用吗National Center for Health Statistics. According to the study, cancer patients and survivors who had nearly twice the risk of suicide mortality compared with the general population included individuals in the lowest-income quartile (1.94 times) and rural counties (1.81 times). On the other hand, cancer patients and survivors living in the highest-income (1.30 times) and urban counties (1.35 times) had comparatively lower risks, although they still had elevated risks compared to the general population.

For all area groups, the suicide mortality risk was the highest within one year after diagnosis and decreased over time. However, among those living in the lowest-income counties, the suicide risk remained nearly twice (1.83 times) that of the general population after more than a decade following cancer diagnosis. On the other hand, those living in the other county groups, including higher-income counties, had no difference from the general population after more than 10 years following cancer diagnosis. This finding highlights that mental distress from financial hardship might worsen during the course of cancer survivorship among those living in the least affluent areas, the researchers said.

In white and Black cancer patients and cancer survivors, the suicide risk was highest among those in the lowest-income counties and comparatively lower in the higher-income areas; regardless of area-level income, these groups had higher risks than the general population. On the other hand, Hispanic cancer patients and cancer survivors in the lowest-income counties did not have a significantly increased risk of suicide mortality, while Hispanic individuals diagnosed with cancer in the highest-income areas had a lower risk of suicide death compared with the general population.

“一个对我们来说最杰出的个人属性是有癌症诊断的亚洲和太平洋岛民。根据我们的数据,在所有收入领域中,该人口的自杀风险始终很高。与普通人群相比,即使是那些生活在最高收入县的人,自杀死亡率的风险也增加了近两倍。”“这一发现可能强调需要在此人群中向患有癌症患者传播有关心理健康服务的更多信息。”

The researchers hope these findings highlight the importance of improving and increasing access to preventive mental health services, especially in low-income and rural areas.

“Patients living with cancer and cancer survivors face many complex challenges, particularly those living in rural or low-income areas. Enhanced telemedicine options for mental health and other health care needs could be one way to increase access to these important services for this population and help reduce their risk of suicide mortality,” Suk said.

Other UTHealth Houston study co-authors included J. Michael Swint, PhD; Kalyani Sonawane, PhD; and Ashish Deshmukh, PhD, MPH. Other co-authors include Young-Rock Hong, PhD, MPH, of the University of Florida; Rachel Wasserman, PhD, with Nemours Children’s Health System; Belinda Azenui, PhD, with Denison University; and Alexander Tsai, MD, PhD, of Massachusetts General Hospital and Harvard Medical School.

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