Spouses of Patients With Cancer Face Elevated Suicide Risk, Study Finds

Spouses of patients with cancer are at a heightened risk of suicide attempts and suicide death, with the risk peaking during the first year following the cancer diagnosis, a study reveals.¹

The risk of suicide attempt was highest in the first year following the diagnosis and decreased over time. | Image credit: pressmaster - stock.adobe.com

The findings emphasize the importance of recognizing and addressing the mental health needs of these caregivers, especially those facing additional challenges such as advanced-stage cancer in their spouse, lower household income, or lack of children. The comprehensive nationwide cohort study conducted in Denmark is published in JAMA Oncology.

“To our knowledge, this nationwide cohort study is the first to show that spouses of patients with cancer have an elevated risk of both suicide attempt and suicide death,” wrote the researchers. “The risk was found to be particularly high during the first year after the spouse’s cancer diagnosis and persisted through the entire 30-year follow up.”

As the burden of cancer continues to increase, it is important to acknowledge that the disease affects not only the patients but also their loved ones. Parents and siblings of children with cancer have been found to suffer from increased psychological morbidity in conjunction with the diagnosis, highlighting the role of health care professionals to provide supportive from the time of diagnosis to cure or palliation.²

“That outcome ultimately is something that you will feel as a doctor, but it's going to be felt much more personally by the patient, by the family members and friends who love them,” said Ravin Ratan, MD, MEd, associate professor, Department of Sarcoma Medical Oncology, Division of Cancer Medicine, in an interview with The American Journal of Managed Care^® (AJMC^®).³ “And so I try really hard to own process, to make sure that we feel like people had the attention that they deserve, that I've been available to them when they needed them.”

The study utilized data from various Danish national health and population registers to identify all patients with a cancer diagnosis from January 31, 1986, to December 31, 2025.¹ Spouses of these patients were also identified, focusing on heterosexual spouses who were aged 18 years and older at the time of the cancer diagnosis.

A total of 409,338 spouses were included in the analysis, excluding those with prior exposure to a spouse with cancer or a previous suicide attempt. For each exposed individual, up to 5 control individuals were randomly selected and matched based on year of birth, sex, and other demographic factors.

Both exposed and unexposed individuals were followed from the date of cancer diagnosis until the occurrence of suicide attempt, suicide death, death from other causes, emigration, or December 31, 2016.

Spouses of patients with cancer had a higher risk of attempting suicide compared with spouses of individuals without cancer (HR, 1.11; 95% CI, 1.02-1.20). Additionally, the risk of suicide death was elevated among spouses of patients with cancer (HR, 1.19; 95% CI, 1.09-1.30).

The risk of suicide attempt was highest in the first year following the diagnosis and decreased over time, while the risk of suicide death was most pronounced within the first 5 years, with the highest risk observed within the first year.

The risk of suicide attempt and suicide death also varied by the type and stage of cancer. Additionally, male spouses, younger spouses, those with lower income and lower educational levels, and those with a history or psychiatric disorders had significantly higher risk of suicide.

“In this nationwide, retrospective cohort study, we observed an increased risk of suicide attempt and suicide death among spouses of patients with cancer in Denmark, especially during the first year after a cancer diagnosis,” wrote the researchers. “Clinical and societal awareness is therefore needed to help prevent suicidal behaviors in this vulnerable population.”

References

1. Liu Q, Yang F, László KD, et al. Suicide attempt and suicide death among spouses of patients with cancer. JAMA Oncol. Published online August 15, 2024. doi:10.1001/jamaoncol.2024.3036

2. Hagedoorn M, Kreicbergs U, Appel C. Coping with cancer: The perspective of patients’ relatives. Acta Oncol. 2011;50(2):205-211. doi:10.3109/0284186x.2010.536165

3. Shaw ML. Caring for patients is a team sport. AJMC^®. Published July 8, 2024. Accessed August 16, 2024. https://www.ajmc.com/view/caring-for-patients-is-a-team-sport