Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Program Number: B025
Session Name: Poster Session
Suicide risk in patients with head and neck cancer.
Cinthia Gabrir Konaka, MSc1; José Guilherme Vartanian, PhD1; Luiz Paulo Kowalski, PhD2; Tarsila Guimarães Vieira da Silva, Dra2; Maria Teresa da Cruz Lourenço, Dra1; 1AC Camargo Cancer Center; 2University Estate São Paulo - USPSuicide is a global phenomenon affecting individuals across diverse borders, cultures, ethnicities, and religions. Particularly in patients with head and neck cancer (HNC), suicide risk remains under-researched despite the high psychological burden associated with the disease. Investigating this risk is essential for identifying specific risk factors, addressing psychological and social needs, and developing effective preventive interventions. Such efforts can enhance psychological support, improve quality of life, and potentially reduce suicide rates among HNC patients. Studies indicate that cancer patients have a higher suicide risk, with newly diagnosed individuals at up to 13 times greater risk. In the case of HNC, the risk is estimated to be 2 to 3 times higher than in other cancer types.
This study aims to identify suicide risk factors in HNC patients by examining predictors of risk or protection, assessing anxiety and depression levels, and evaluating quality of life. The research follows a prospective design with 181 recently diagnosed patients, including oral cavity, pharynx, larynx, advanced skin and thyroid cancer patients. Key instruments included the University of Washington Quality of Life Questionnaire (UW-QOL), the Hospital Anxiety and Depression Scale (HADS), and the suicide risk module of the Mini International Neuropsychiatric Interview (MINI).
The findings showed a significant disparity between patients with thyroid cancer and those with other HNC diagnoses. Logistic regression analysis revealed a markedly higher suicide risk in the non-thyroid cancer group (OR 9.85; CI 1.40–66.80) compared to thyroid cancer patients (OR 0.10; CI 0.15–0.71). Specifically, patients with oral cavity cancer demonstrated heightened risk, particularly when exhibiting anxiety tendencies and undergoing multimodal and intensive treatments (e.g., surgery plus radiotherapy +/- chemotherapy, chemoradiation and reconstructive procedures). Additionally, factors such as low self-rated quality of life, male gender, single marital status, limited family support, and a history of mental illness were associated with increased risk.
For thyroid cancer patients, depressive symptoms were notably prevalent (OR 4.11), suggesting that prior depression or other mental health disorders may amplify emotional distress and suicide risk. Our data underscore the need for tailored treatment approaches and screening procedures that prioritize mental health, particularly among patients with a history of depression.
