July 23 (UPI) -- People with head and neck cancers have an up to five times higher risk for suicide compared to the general population, an analysis published Friday by JAMA Otolaryngology-Head and Neck Surgery found.
Those living in rural areas who suffer from these diseases, which include cancers of the mouth, sinuses and throat, are more than five times as likely to die by suicide than the general population, the data showed.
Head and neck cancer patients who live in urban and suburban areas are almost three times as likely to die by suicide, despite having more access to disease treatment and mental health support services, the researchers said.
In terms of suicide risk, head and neck cancer patients rank behind only those with pancreatic cancer, according to the researchers, based on their findings in a previous study.
"Hope really drives cancer treatment and, like pancreatic cancer, head and neck cancers typically have high fatality rates and cause high levels of pain," study co-author Dr. Nosayaba Osazuwa-Peters told UPI in a phone interview.
"That creates feelings of hopelessness, said Osazuwa-Peters, an assistant professor of head and neck surgery and communication sciences at Duke University School of Medicine in Durham, N.C.
Another factor is that many people with head and neck cancers exhibit outward signs of their disease, either in terms of scarring on their face and neck area or complications that affect their ability to swallow and taste food, according to Osazuwa-Peters.
"This can make them self-conscious and drive them further into isolation, which adversely affects their mental health," he said.
Collectively, head and neck cancers account for about 4% of all cancers in the United States, the disease information site Cancer.net estimates.
Roughly 67,000 people are diagnosed with the diseases annually, and nearly 15,000 die from them in a given year, according to the site.
Although suicide rates among cancer patients have declined over the past 20 years, due largely to improved treatments and survival, diseases with more challenging symptoms, and poorer prognoses, tend to see more deaths caused by suicide, according to the National Cancer Institute.
For this study, Osazuwa-Peters and his colleagues analyzed data on nearly 135,000 people with head and neck cancers over a 10-year period.
Within this study population, 405 deaths by suicide were identified, the researchers said.
Rates of death by suicide were nearly twice as high among those living in rural areas compared to those living in urban and "metropolitan" regions.
The difference is likely due to the lack of mental health services in more rural areas, as well lower overall access to cancer care that often is "centralized" in or near larger cities, according to Osazuwa-Peters.
"When you receive a diagnosis of a head and neck cancer, or any cancer, you don't know what's going to happen to you or whether you can be treated successfully," Osazuwa-Peters said.
"This can cause depression and anxiety, which may lead to thoughts of suicide, so without mental health care services integrated into overall cancer treatment, it can make things very difficult for these patients," he said.