Depression and Suicide Ideas of Cancer Patients and Influencing Factors in South Korea

  • Lee, Su Jin (National Cancer Center in Korea) ;
  • Park, Jong Hyock (National Cancer Center in Korea) ;
  • Park, Bo Young (National Cancer Center in Korea) ;
  • Kim, So Young (National Cancer Center in Korea) ;
  • Lee, Il Hak (Graduate School of Public Health Yonsei University) ;
  • Kim, Jong Heun (National Cancer Center in Korea) ;
  • Koh, Dai Ha (Preventive Medicine, Chonbuk National University) ;
  • Kim, Chang-Hoon (Office of Public Health, Department of Cancer Management, Pusan National University Hospital) ;
  • Park, Jae Hyun (Department of Social and Preventive Medicine, Sung Kyun Kwan University College of Medicine) ;
  • Sohn, Myong Sei (Graduate School of Public Health Yonsei University)
  • Published : 2014.04.01


Background: This study compared risk factors for depression and suicidal ideas among cancer patients for comparison with the general population, and identified influencing factors. Materials and Methods: We analyzed data from 2,472 cancer patients in the National Cancer Center and nine Regional Cancer Centers and frequency-matched data for age and sex from 2,349 members of the general population who completed the National Health and Nutrition Examination Survey in 2008. Logistic regression analysis was used to identify factors affecting depression and suicidal ideas. Results: Cancer patients were not likely to have more depression (OR=0.96, 95%CI=0.79-1.18) and were less likely to have suicidal ideas (OR=0.64, 95%CI=0.53-0.79) compared to the general population. Female sex, more stress, and lower quality of life were influencing factors. The additional risk factors for suicidal ideas among cancer patients included income (OR=0.62, 95%CI=0.43-0.91), smoking (OR=1.63, 95% CI=1.06-2.50), recurrence (OR=1.50, 95%CI=1.15-1.95), and chemotherapy (OR=1.66, 95%CI=1.26-2.19). Conclusions: No differences appeared in depression rates between cancer patients and the general population, and cancer patients were less likely to have suicidal ideas. However, cancer patients were likely to have more risk factors than the general population, and those classified as being at high risk of suicide should receive distress management and social economic support, from early in the treatment process.


Cancer patients;depression;distress management;social economic support;suicidal ideas;Korea


Supported by : National Cancer Center in Korea


  1. Shim E (2010). Distress and its associated factors in korean cancer patients: 'desire for hastened death', anxiety and depression, Korean Psychological Association annual conference, 490-1.
  2. Shin D, Ahn E, Kim H, et al (2010). Non-cancer mortality among long-term survivors of adult cancer in Korea: national cancer registry study. Cancer Causes Control, 21, 919-29.
  3. Shin D, Nam J, Kwon Y, et al (2008). Comorbidity in diseasefree survivors of cervical cancer compared with the general female population. Oncology, 74, 207-15.
  4. Taylor A, Dal Grande E, Gill T, et al (2007). Detecting determinants of suicidal ideation: South Australian surveillance system results. Int J Public Health, 52, 142-52.
  5. Zabora J, BrintzenhofeSzoc K, Curbow B, et al (2001). The prevalence of psychological distress by cancer site. Psychooncol, 10, 19-28.<19::AID-PON501>3.0.CO;2-6
  6. Montazeri A (2004).The role of depression in the development of breast cancer: analysis of registry data from a single institute. Asian Pac J Cancer Prev, 5, 316-9.
  7. Maneeton B, Maneeton N, Mahathep P (2012). Prevalence of depression and its correlations: a cross-sectional study in Thai cancer patients. Asian Pac J Cancer Prev, 13, 2039-43.
  8. Miller M, Hemenway D, Rimm E (2000). Cigarettes and suicide: A prospective study of 50,000 men. Am J Public Health, 90, 768-73.
  9. Misono S, Weiss N, Fann J, et al (2008). Incidence of suicide in persons with cancer. J Clin Oncol, 26, 4731-8.
  10. Mitchell AJ, Chan M, Bhatti H, et al (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol, 12, 160-74.
  11. National Cancer Institute (2004). President's Cancer Panel, Living beyond Cancer, Finding a New Balance.
  12. Park J, Park E, Kim S, et al (2008). Job loss and re-employment of cancer patients in Korean employees: a nationwide retrospective cohort study. J Clin Oncol, 26, 1302-9.
  13. Park S, Kim B, Han H, et al (2009). Effect of Cancer Diagnosis on Smoking Behavior. Korean J Fam Med, 30, 681-7.
  14. Pirkis JE, Burgess PM, Dunt D (2000). Suicidal ideation and suicide attempts among Australian adults, Crisis, 21, 16-25.
  15. Pirkola SP, Suominen K, Isometsa ET (2004). Suicide in alcoholdependent individuals: Epidemiology and management. CNS Drugs, 18, 423-36.
  16. Recklitis C, Diller L, Li X, et al (2010). Suicide ideation in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol, 28, 655-61.
  17. Choi H (2011). An Analysis on Depression and Suicide Ideation of Korean Adults by using Korea National Health and Nutrition Examination Survey, Kangwon University
  18. Bjorkenstam C, Edberg A, Ayoubi S, et al (2005). Are cancer patients at higher suicide risk than the general population? A nationwide register study in Sweden from 1965 to 1999. Scand J Public Health, 33, 208-214.
  19. Bruce M, Ten Have T, Reynolds III C, et al (2004). Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: a randomized controlled trial. JAMA, 291, 1081-1091.
  20. Cancer registration. Statistics Program (2008). Annual report 2008,
  21. Costanzo E, Lutgendorf S, Mattes M, et al (2007). Adjusting to life after treatment: distress and quality of life following treatment for breast cancer. Br J Cancer, 97, 1625-31
  22. Fanger PC, Azevedo RC, Mauro ML, et al (2010). Depression and suicidal behavior of cancer inpatients: prevalence and associated factors. Rev Assoc Med Bras, 56, 173-8.
  23. Kamen BA (2010). Clinical aspects of pharmacogenetics of pain and co-morbidities of emotional distress. Asian Pac J Cancer Prev, 11, 27-30.
  24. Kim S, Kang S, Kim Y, et al (2010). Prevalence and predictors of anxiety and depression among cervical cancer survivors in Korea. Int J Gynecol Cancer, 20, 1017-1024.
  25. Kim Y, Lee K (2010). Relationship of social support and meaning of life to suicidal thoughts in cancer patients. J Korean Acad Nurs, 40, 524-32
  26. Louhivuori K, Hakama M(1979). Risk of suicide among cancer patients. Am J Epidemiol, 109, 59-65.
  27. Ahn E, Shin D, Cho S, et al (2010). Suicide rates and risk factors among Korean cancer patients, 1993-2005. Cancer Epidemiol Biomarkers Prev, 19, 2097-105.
  28. Akechi T, Nakano T, Akizuki N, et al (2002). Clinical factors associated with suicidality in cancer patients. Jpn J Clin Oncol, 32, 506-511.
  29. Amir M, Ramati A (2002). Post-traumatic symptoms, emotional distress and quality of life in long-term survivors of breast cancer. a preliminary research. J Anxiety Disord, 16, 191-206.
  30. Charlson ME, Pompei P, Ales KL, et al (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis, 40, 373-83

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