Suicide risk among prostate cancer patients before and after the implementation of prostate-specific antigen-based prostate screening in Lithuania in 2006

Abstract

Despite good prognosis, increased suicide rates are reported for prostate cancer. The aim of this study was to assess the risk of suicide among prostate cancer patients before and after the start of nation-wide prostate-specific antigen (PSA)-based screening programme. Prostate cancer cases diagnosed between 2000 and 2011 were identified from the population-based Lithuanian Cancer Registry and analysis was conducted in 2018. Analysis was stratified by period of diagnosis, age, Gleason score, extent of disease, and time since diagnosis. Standardized mortality ratios (SMRs) were used to assess suicide risk. SMRs were calculated by dividing the observed number of suicides among prostate cancer patients by the expected number of suicides from the general population. Overall, 25 786 prostate cancer cases were diagnosed 2000–2011, and 135 suicides occurred among them compared with expected number of 133 (SMR: 1.10; 95% confidence interval (CI) 0.85–1.20). The suicide risk among prostate cancer patients was 1.08 before and 0.97 after the start of nation-wide PSA-based screening programme. Statistically significant increase in suicide risk was associated with Gleason score 8–10 in the prescreening period (SMR: 2.45; 95% CI 1.23–4.90). Suicide risk among prostate cancer patients before and after introduction of nation-wide PSA-based screening programme is similar to that in the general population.