Teenagers and young adults who are diagnosed with cancer are 60% more likely to commit or attempt suicide, a study has found.
The risk was greatest during the first year after diagnosis, when cancer patients aged between 15 and 30 were 1.5 times more likely to display suicidal behaviour than young people without cancer. Researchers attributed the suicidal behaviours as a manifestation of "extreme emotional stress" brought on by being diagnosed with the disease.
Lead scientist Donghao Lu, from the Karolinska Institute in Sweden, said: "We found that there were 22 suicides among the cancer patients versus 14 expected and 136 attempts at suicide versus 80 expected.
"This equates to an extra 64 instances of suicidal behaviour among the 12,669 young cancer people.
"As far as we are aware, this is the first study to look at suicidal behaviour following a cancer diagnosis in adolescents and young adults.
"Given that young people are still developing their coping strategies for stress, they may be more affected than adults when facing major adversity such as a cancer diagnosis.
"Although the absolute risk of suicidal behaviour is modest among the cancer patients, it emphasises the need to support and carefully monitor these vulnerable young people."
The study looked at data on almost eight million Swedes aged 15 and over between 1987 and 2009. During an average 17.4 years of follow up a total of 105,868 cases of suicidal behaviour were reported.
Almost three times more young men than women killed themselves after learning they had cancer, whereas more women than men made unsuccessful suicide attempts.
An increased risk of suicidal behaviour was associated with most cancers, but not thyroid, testicular and skin cancers.
This may because young people with these cancers generally have a good prognosis, the researchers believe.
Yet despite good survival rates, the risk of suicidal behaviour tripled among women diagnosed with cervical cancer between the ages of 20 and 29, and was six-fold higher in the first year after diagnosis.
"Suicide behaviours can be seen as manifestations of the extreme emotional stress induced by the cancer diagnosis," said Mr Lu.
"We believe that the evident risk of suicidal behaviour is likely to represent just the tip of the iceberg of mental suffering in these young cancer patients.
"Our findings also have important implications for the relatives and other people involved in the healthcare of the young cancer patients.
"They emphasise the need for mental care to be included in the clinical care of these patients, particularly those with pre-existing psychiatric conditions, or with poor prognosis.
"Ideally, this task should be a cooperation with different parties, including the medical professionals, psychological professionals, family members, as well as social workers."
The findings are reported in the journal Annals Of Oncology.
Useful websites and helplines:
Samaritans, open 24 hours a day, on 08457 90 90 90
Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
Students Against Depression, a website by students, for students.
HopeLine runs a confidential advice helpline if you are a young person at risk of suicide or are worried about a young person at risk of suicide. Mon-Fri 10-5pm and 7pm-10pm. Weekends 2pm-5pm on 0800 068 41 41
Mental Wealth UK To join the community or launch a student group contact the charity on firstname.lastname@example.org