Lung cancer patients are known to have elevated risk of suicide compared with the general population, but long-term temporal patterns and differences by treatment modality have not been fully characterized. This nationwide cohort study aimed to quantify longitudinal suicide risk among patients who underwent lung resection and to compare that risk with age- and sex-matched controls. The study also examined how suicide risk varied over time by treatment modality (surgery alone versus adjuvant chemotherapy and/or radiotherapy) and by patient characteristics.
The investigators identified 37,215 individuals newly diagnosed with lung cancer between 2010 and 2017 who underwent lung resection within 1 year of diagnosis. Each case was matched 1:3 on age and sex to control individuals. The abstract reports the cohort mean age as 64.0 years and that 62.5% were male. Mean follow-up time for the cohort was 7.6 years. The number of suicides observed among lung cancer patients and the incidence rate are reported below.
Suicide risk was estimated using a competing risk framework, with subdistribution hazard ratios (sHRs) and 95% confidence intervals (CIs) reported. The analysis evaluated risk over time, including a focus on the first postoperative year and subsequent years, and compared risk across treatment modalities and patient subgroups. Specific details about additional covariates, data sources beyond the reported cohort, or model specifications are not detailed in the abstract and therefore are not reported here.
During a mean follow-up of 7.6 years there were 154 suicides among the lung cancer patients, corresponding to an incidence rate of 0.6 per 1,000 person-years. Suicide risk for the cohort was highest in the first year after surgery, with an overall first-year subdistribution hazard ratio of 1.88 (95% CI 1.23–2.87) compared with matched controls. After the first postoperative year, the elevated risk declined over subsequent years.
Treatment modality showed marked differences in early and long-term suicide risk. Patients who underwent surgery alone had an increased suicide risk during the first postoperative year (sHR 1.66, 95% CI 1.02–2.69) that decreased over time.
In contrast, patients who received adjuvant treatments experienced substantially higher initial suicide risk and a more persistent excess risk. For example, the combination of surgery plus radiotherapy was associated with a notably elevated first-year risk (sHR 7.00, 95% CI 3.00–16.37). The abstract indicates that patients treated with adjuvant chemotherapy or radiotherapy not only had a higher initial risk but also maintained a moderate increase in suicide risk even beyond 5 years of follow-up.
These findings suggest that receipt of multimodal therapy identifies a subgroup with both a sharp early peak in suicide risk and a longer-lasting moderate elevation in risk compared with patients treated with surgery alone.
The study reports subgroup differences in first-year suicide risk. An especially elevated first-year suicide risk was observed among younger adults aged 20–49 years, among males, and among never smokers. The abstract does not provide subgroup-specific hazard ratios or CIs for all combinations of these characteristics; only the presence of pronounced risk elevation in these groups is reported.
The authors conclude that suicide risk among lung cancer patients who undergo resection is highest during the first postoperative year. Risk is particularly elevated for patients receiving multimodal adjuvant therapy and for certain subgroups—younger adults (20–49 years), males, and never smokers. The study highlights the need to prioritize early, tailored psychosocial support and survivorship interventions targeted to high-risk groups to help mitigate both early and longer-term suicide risk.
The abstract provides core cohort characteristics, incidence counts, and key subdistribution hazard ratios, but it does not include some methodological and contextual details in the abstract. Specifically, the abstract does not report the data source coding, the full list of covariates adjusted for in the competing risk models, exact definitions of treatment timing or staging, or the study's limitations beyond the results presented. Those elements may be in the full text but were not reported in the abstract and therefore are not described here.