We know that any life-threatening health diagnosis, such as cancer, carries a suicide risk (Matthews, 2023).
Fitzgerald et al (2025) wanted to update older studies and ascertain the extent to which people who have been recently diagnosed for the first time with different kinds and stages of cancer, have suicide rates that are higher than those with no such diagnosis. This is of particular importance now, as cancer rates increase in the context of an aging population, augmented screening, and better diagnostic tools.
In 2020 (the most recent year for which these statistics are available), 19 million people around the world were diagnosed with a new cancer (Sung et al., 2021).
19 million people around the world were diagnosed with a new cancer in 2020; are all these people at greater risk of suicide?
Methods
Fitzgerald et al (2025) conducted a longitudinal cohort study on the population of Denmark, using data collected from everyone aged 15 years and older (N = 6,987,998) between 2000 and 2021. They considered 30 different types of first-time diagnosed cancers (lung, breast, pancreas, etc.) across 4 stages of invasiveness, from localised presence to distant metastatic spread. Death by suicide was used as the outcome measure.
The researchers compared suicide rates for people diagnosed with cancer for the first time to matched individuals without a cancer diagnosis. They calculated adjusted incidence rate ratios (aIRRs) using Poisson regression models that matched for calendar period (2000-2009 vs 2010-2021), sex, age, civil status, education, household income, Charlson comorbidity index, psychiatric disorders, and previous suicide attempts.
Results
Fitzgerald et al. followed almost seven million people (50% females) from 2000 to 2021. Of these, 10% of the total (707,513) were diagnosed with cancer. During the 5 years of follow-up, there were 601 suicides, yielding a suicide rate of 34.7 per 100,000 person-years, as compared to the cancer-free population, which had a suicide rate of 13.3.
In total, those diagnosed with any of the cancers included in the study were more than twice as likely to die by suicide (adjusted Incident Rate Ratio [aIRR] 2.2]) than those not diagnosed with cancer during this period.
Suicide rates were highest in the first six months after diagnosis (aIRR 3.9), and then the next six months (aIRR 2.4), after which the aIRRs held relatively steady between 1.5 and 2.
As might be expected, suicide rates varied greatly across metastatic stage. Those with stage 4 tumours had a markedly higher suicide rate (aIRR 3.1) than those diagnosed with lower stages of cancer (stages 1 and 2 aIRR 1.0; stage 3 aIRR 1.7).
Type of cancer also showed wide variations in suicidality. The cancers that yielded the highest suicide rates per person diagnosed were pancreas (aIRR 7.4) and oesophagus (aIRR 5.7), both of which have a poor prognosis. The lowest significant suicide rate occurred with prostate cancer (aIRR 1.3). No statistical difference was found for cancer of the oral cavity, thyroid, cervix, and melanoma. The three cancers that claimed the most suicide victims in total were prostate (n = 106), lung (n = 74) and breast (n = 67).
Note: All aIRRs reported are at the 95% Confidence Interval.
The authors included tables showing the suicide incident rate breakdown by age and sex, but did not report these numbers in the Results section of the article, or discuss them further.
In a Danish population study, people diagnosed with cancer were more than twice as likely to die by suicide (compared to the rest of the population) within the first 5 years after diagnosis.
Conclusions
Across the entire population of Denmark for the years 2000-2021, people diagnosed with cancer were more than twice as likely than others to die by suicide within the first 5 years after diagnosis. The higher the cancer stage, the worse the prognosis, and the sooner after diagnosis, the higher the risk of suicide.
There was also a period effect, with a somewhat lower rate for cancers diagnosed from 2010–2021 than between 2000 and 2009. The authors suggest that this:
could suggest that earlier diagnostics, better treatment options, focus on subsequent depression and provision of palliative care may have improved the health-related quality of life in recent years.
A cancer diagnosis is a significant suicide risk. The more serious the prognosis and the sooner following diagnosis, the higher the risk.
Strengths and limitations
Because of its systematic nationwide data collection methodology, this study provides solid evidence of suicide risk following a cancer diagnosis, confirming and fine-tuning findings from previous studies on this topic.
The researchers adjusted the data for age, sex, civil status, education, income, Charlson comorbidity index, and previous psychiatric disorders (including suicide attempts). This allowed them to take these factors out of consideration and assess more purely the risk of suicide for various types and stages of cancer.
While adjusting for these variables strengthens the findings in some ways, there’s also valuable information lost. I would very much like to have seen a breakdown of suicide by socioeconomic status, ethnicity, and the other factors that were adjusted out of the primary analyses.
The researchers included data in chart form that were not reported or discussed. I found some of these findings noteworthy, including the large sex differences in suicide rates. Males diagnosed with cancer had an incident rate of 54.2 whereas the equivalent for females was 17.2. The differences across age were similarly striking, starting with an incident rate of 12.9 in the 15-44 years category and steadily rising to an incident rate of 59 for those over 85. I would love to have seen some discussion of these findings, as well as access to the other differences that were adjusted out of the primary analyses.
This was a comprehensive and highly reliable study showing suicide risk differences across different types and stages of cancer in the five years following diagnosis.
Implications for practice
This study confirms previous findings showing the importance of psychological support for those diagnosed with cancer. This support is particularly urgent for people experiencing the most aggressive cancers, especially in the higher metastatic stages.
These data support educating medical practitioners who work in oncology settings about the importance of psychological support for people diagnosed with cancers with a poor prognosis, most especially pancreatic and oesophageal cancers. This should be done at the time of diagnosis, and for at least the six months following that.
Ideally, high-risk cancer patients should be provided with collaborative care in settings that combine psychological, surgical, and pharmacological interventions. Additionally, patients experiencing advanced disease should be offered timely and proactive palliative care options. Psychosocial and palliative support options can reduce patients’ anxiety and improve their symptoms.
This study has personal relevance for me. As I move through age categories with an increasingly higher risk for suicide following cancer diagnosis, I see more and more friends and family members facing life-threatening cancer diagnoses. I’m glad to see a study like this one that looks carefully at the risk factors and provides practitioners with reliable information that can work to prevent unnecessary suffering.
High-risk cancer patients should be provided with collaborative care in settings that combine psychological, surgical, pharmacological, and palliative options.
Statement of interests
None.
Links
Primary paper
Fitzgerald, C., Dalton, S., Fredriksen, H., Morch, L., Skovund, C., Nordentoft, M. & Erlangsen, A. (2025) Association between recent cancer and suicide: Danish national cohort study. British Journal of Psychiatry 1–6. https://doi.org/10.1192/bjp.2025.10363
Other references
Matthews, D. Does a diagnosis of severe physical illness elevate suicide risk? The Mental Elf, Feb 2023.
Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., & Bray, F. (2021). Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians, 71(3), 209-249.
