{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T15:12:35Z","timestamp":1784214755636,"version":"3.55.0"},"reference-count":93,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:sec id=\"ab-coi260022-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Patients with cancer experience significantly higher rates of suicidal self-directed violence (SSDV; defined as both fatal and nonfatal suicide attempts) than the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi260022-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess longitudinal risks and methods for SSDV among veterans and identify associated risk factors to improve screening and prevention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi260022-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This national cohort study of veterans with cancer was conducted between January 2014 and December 2023. Data from established oncology and suicide registries and the Veterans Health Administration (VA) were used. Data were analyzed from January 2025 to February 2026.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi260022-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Diagnosis of invasive solid or hematologic cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi260022-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary outcome was SSDV and rates per 100\u202f000 person-years. Risk factors for SSDV were estimated as adjusted hazard ratios (aHRs) from multivariable Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi260022-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 292\u202f271 veterans (mean [SD] age, 69.0 [9.4] years; 7108 female [2%]; 2664 American Indian or Alaska Native [1%]; 1365 Asian [1%]; 62\u202f538 Black or African American [21%]; 13\u202f965 Hispanic or Latino [5%]; 2306 Native Hawaiian or Other Pacific Islander [1%]; 219\u202f205 White [75%]), there were 2400 SSDV events (1%; overall rate, 203 [95% CI, 195-211] per 100\u202f000 person-years). The most common method used was poisoning (eg, opioids; 617 attempts [26%]). Estimated SSDV probabilities were highest for those with central nervous system (CNS), pancreas, head and neck, liver and biliary system, and thyroid cancer types. Veterans with severe frailty (544 [95% CI, 457-648] events per 100\u202f000 person-years), advanced cancer (261 [95% CI, 233-293] events per 100\u202f000 person-years), chronic mental illness (419 [95% CI, 399-439] events per 100\u202f000 person-years), and high pain scores (236 [95% CI, 192-210] events per 100\u202f000 person-years) had high SSDV rates compared with the overall cohort. Younger age (\u226445 years; 643 [95% CI, 547-756] events per 100\u202f000 person-years), female sex (369 [95% CI, 306-445] events per 100\u202f000 person-years), American Indian or Alaska Native race (286 [95% CI, 201-407] events per 100\u202f000 person-years), and CNS (394 [95% CI, 311-500] events per 100\u202f000 person-years) and thyroid (359 [95% CI, 290-445] events per 100\u202f000 person-years) cancers had high rates of nonfatal attempts. Increased SSDV hazards (6 months postdiagnosis) occurred among veterans of Asian compared with White race (aHR, 2.55; 95% CI, 1.12-5.76), unmarried veterans (aHR, 1.83; 95% CI, 1.47-2.27), veterans with CNS (aHR, 2.07; 95% CI, 1.13-3.80) or head and neck (aHR, 1.67; 95% CI, 1.13-2.48) compared with lung cancer, and veterans with advanced cancer (aHR, 1.30; 95% CI, 1.00-1.68). Risk for most veterans decreased over time after diagnosis; however, risk remained elevated 5 years postdiagnosis for younger veterans (aged \u226445 vs 46-64 years; aHR, 1.58; 95% CI, 1.29-1.94), unmarried veterans (aHR, 1.48; 95% CI, 1.35-1.62), veterans with CNS vs lung cancer (aHR, 1.63; 95% CI, 1.22-1.27), and veterans with advanced cancer (aHR, 1.30; 95% CI, 1.14-1.50).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-coi260022-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This study found that veterans with cancer were at risk for SSDV that persisted years into survivorship. Previously overlooked high risk, subgroups, such as younger veterans, Asian veterans, or veterans with thyroid cancer, stress the need to systematically track all suicidal behaviors, not just fatal attempts, to inform tailored screening and prevention strategies as a key component of cancer care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaoncol.2026.1459","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T15:30:22Z","timestamp":1779982222000},"page":"741","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal Risk for Suicidal Self-Directed Violence Among Veterans With Cancer"],"prefix":"10.1001","volume":"12","author":[{"given":"Donald R.","family":"Sullivan","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health & Science University, Portland"},{"name":"Division of Oncological Sciences, Knight Cancer Institute, School of Medicine, Oregon Health & Science University, Portland"},{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Disher","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Oregon Health & Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E.","family":"Rosa","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara A.","family":"Vlajic","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Handley","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Scott","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren M.","family":"Denneson","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon"},{"name":"Department of Psychiatry, Oregon Health & Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meike","family":"Niederhausen","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon"},{"name":"Oregon Health & Science University\u2013Portland State University School of Public Health, Oregon Health & Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick G.","family":"Lyons","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health & Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly C.","family":"Vranas","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon"},{"name":"Section of Pulmonary and Critical Care Medicine, VA Portland Health Care System, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chrisopher G.","family":"Slatore","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health & Science University, Portland"},{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon"},{"name":"Section of Pulmonary and Critical Care Medicine, VA Portland Health Care System, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Kutney-Lee","sequence":"additional","affiliation":[{"name":"Veteran Experience Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania"},{"name":"Center for Healthcare Evaluation, Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania"},{"name":"Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerri M.","family":"Winters-Stone","sequence":"additional","affiliation":[{"name":"Division of Oncological Sciences, Knight Cancer Institute, School of Medicine, Oregon Health & Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon M.","family":"Nugent","sequence":"additional","affiliation":[{"name":"Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon"},{"name":"Department of Psychiatry, Oregon Health & Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4","key":"coi260022r4","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1038\/s41591-022-01745-y","article-title":"Suicide risk and mortality among patients with cancer.","volume":"28","author":"Heinrich","year":"2022","journal-title":"Nat Med"},{"issue":"3","key":"coi260022r5","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1002\/wps.20909","article-title":"The critical distinction between suicidal ideation and suicide attempts.","volume":"20","author":"Klonsky","year":"2021","journal-title":"World Psychiatry"},{"key":"coi260022r6","doi-asserted-by":"publisher","first-page":"c3222","DOI":"10.1136\/bmj.c3222","article-title":"Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study.","volume":"341","author":"Runeson","year":"2010","journal-title":"BMJ"},{"key":"coi260022r7","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1186\/1471-2458-11-374","article-title":"Military veteran mortality following a survived suicide attempt.","volume":"11","author":"Weiner","year":"2011","journal-title":"BMC Public Health"},{"issue":"4","key":"coi260022r8","doi-asserted-by":"publisher","first-page":"341","DOI":"10.3322\/caac.21837","article-title":"Cancer diagnosis and treatment in working-age adults: Implications for employment, health insurance coverage, and financial hardship in the United States.","volume":"74","author":"Yabroff","year":"2024","journal-title":"CA Cancer J Clin"},{"issue":"33","key":"coi260022r9","doi-asserted-by":"publisher","first-page":"3984","DOI":"10.1200\/JCO.2016.66.8459","article-title":"Longitudinal changes in depression symptoms and survival among patients with lung cancer: a national cohort assessment.","volume":"34","author":"Sullivan","year":"2016","journal-title":"J Clin Oncol"},{"issue":"1","key":"coi260022r10","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1097\/00005650-200301000-00013","article-title":"Measuring chronic patients\u2019 feelings of being a burden to their caregivers: development and preliminary validation of a scale.","volume":"41","author":"Cousineau","year":"2003","journal-title":"Med Care"},{"issue":"2","key":"coi260022r11","doi-asserted-by":"publisher","first-page":"163","DOI":"10.2190\/PM.40.2.c","article-title":"It\u2019s not over when it\u2019s over: long-term symptoms in cancer survivors\u2014a systematic review.","volume":"40","author":"Harrington","year":"2010","journal-title":"Int J Psychiatry Med"},{"issue":"1","key":"coi260022r12","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3322\/caac.21871","article-title":"Cancer statistics, 2025.","volume":"75","author":"Siegel","year":"2025","journal-title":"CA Cancer J Clin"},{"issue":"11","key":"coi260022r13","doi-asserted-by":"publisher","first-page":"1784","DOI":"10.1093\/jnci\/djae135","article-title":"Prevalence of cancer survivors in the United States.","volume":"116","author":"Tonorezos","year":"2024","journal-title":"J Natl Cancer Inst"},{"issue":"1","key":"coi260022r14","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.51863","article-title":"Suicide risk among individuals diagnosed with cancer in the US, 2000-2016.","volume":"6","author":"Hu","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"1","key":"coi260022r15","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1038\/s41398-024-02917-9","article-title":"Trends in cancer-related suicide in the United States: a population-based epidemiology study spanning 40 years of data.","volume":"14","author":"Liu","year":"2024","journal-title":"Transl Psychiatry"},{"issue":"10","key":"coi260022r16","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.29913","article-title":"Analysis of suicide after cancer diagnosis by us county-level income and rural vs urban designation, 2000-2016.","volume":"4","author":"Suk","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"29","key":"coi260022r17","doi-asserted-by":"publisher","first-page":"4731","DOI":"10.1200\/JCO.2007.13.8941","article-title":"Incidence of suicide in persons with cancer.","volume":"26","author":"Misono","year":"2008","journal-title":"J Clin Oncol"},{"issue":"7","key":"coi260022r18","doi-asserted-by":"publisher","first-page":"598","DOI":"10.1080\/09540261.2021.1901668","article-title":"A cohort study of initial self-harm events: method-specific case fatality of index events, predictors of fatal and nonfatal repetition, and frequency of method-switching.","volume":"33","author":"Thomas","year":"2021","journal-title":"Int Rev Psychiatry"},{"key":"coi260022r19","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/j.jad.2018.11.001","article-title":"Patterns of self-harm methods over time and the association with methods used at repeat episodes of non-fatal self-harm and suicide: a systematic review.","volume":"245","author":"Witt","year":"2019","journal-title":"J Affect Disord"},{"issue":"11","key":"coi260022r20","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1176\/appi.ajp.2016.15070854","article-title":"Suicide attempt as a risk factor for completed suicide: even more lethal than we knew.","volume":"173","author":"Bostwick","year":"2016","journal-title":"Am J Psychiatry"},{"issue":"9","key":"coi260022r21","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.26822","article-title":"Incidence of and factors associated with nonfatal self-injury after a cancer diagnosis in Ontario, Canada.","volume":"4","author":"Noel","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"2","key":"coi260022r22","doi-asserted-by":"publisher","first-page":"E291","DOI":"10.9778\/cmajo.20220157","article-title":"The impact of a cancer diagnosis on nonfatal self-injury: a matched cohort study in Ontario.","volume":"11","author":"Nguyen","year":"2023","journal-title":"CMAJ Open"},{"issue":"3","key":"coi260022r23","doi-asserted-by":"publisher","first-page":"76","DOI":"10.6004\/jnccn.2024.7083","article-title":"association between nonfatal self-injury and survival following a cancer diagnosis: a comparative population-based cohort study.","volume":"23","author":"Eskander","year":"2025","journal-title":"J Natl Compr Canc Netw"},{"issue":"5","key":"coi260022r24","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2022.0203","article-title":"Association of patient-reported outcomes with subsequent nonfatal self-injury after a new cancer diagnosis.","volume":"8","author":"Hallet","year":"2022","journal-title":"JAMA Oncol"},{"issue":"12","key":"coi260022r25","doi-asserted-by":"publisher","first-page":"3112","DOI":"10.1093\/annonc\/mdt415","article-title":"Suicide and suicide attempt after a cancer diagnosis among young individuals.","volume":"24","author":"Lu","year":"2013","journal-title":"Ann Oncol"},{"issue":"5","key":"coi260022r26","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1038\/sj.bjc.6603617","article-title":"Hospital admissions and deaths relating to deliberate self-harm and accidents within 5 years of a cancer diagnosis: a national study in Scotland, UK.","volume":"96","author":"Camidge","year":"2007","journal-title":"Br J Cancer"},{"key":"coi260022r27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2025.112326","article-title":"Incidence of suicide and suicide attempts following a diagnosis of cancer: a nationwide study using Danish registry data.","volume":"196","author":"Christiansen","year":"2025","journal-title":"J Psychosom Res"},{"key":"coi260022r28","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.102826","article-title":"Early, medium and long-term mental health in cancer survivors compared with cancer-free comparators: matched cohort study using linked UK electronic health records.","volume":"76","author":"Forbes","year":"2024","journal-title":"EClinicalMedicine"},{"issue":"4","key":"coi260022r29","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1038\/s41591-022-01740-3","article-title":"Cumulative burden of psychiatric disorders and self-harm across 26 adult cancers.","volume":"28","author":"Chang","year":"2022","journal-title":"Nat Med"},{"issue":"11","key":"coi260022r30","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1001\/jamaoto.2021.2625","article-title":"Risk of suicidal self-directed violence among us veteran survivors of head and neck cancer.","volume":"147","author":"Nugent","year":"2021","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"7","key":"coi260022r31","doi-asserted-by":"publisher","first-page":"e1883","DOI":"10.7205\/MILMED-D-16-00371","article-title":"Cancer incidence among patients of the U.S. Veterans Affairs health care system: 2010 update.","volume":"182","author":"Zullig","year":"2017","journal-title":"Mil Med"},{"issue":"6","key":"coi260022r32","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2020-001038","article-title":"Management of breathlessness in patients with cancer: ESMO Clinical Practice Guidelines\u2020.","volume":"5","author":"Hui","year":"2020","journal-title":"ESMO Open"},{"issue":"26","key":"coi260022r34","doi-asserted-by":"publisher","first-page":"2456","DOI":"10.1056\/NEJMp1802313","article-title":"Making Neighborhood-disadvantage metrics accessible\u2014the neighborhood atlas.","volume":"378","author":"Kind","year":"2018","journal-title":"N Engl J Med"},{"issue":"7","key":"coi260022r36","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1377\/hlthaff.2014.0054","article-title":"Insights from advanced analytics at the Veterans Health Administration.","volume":"33","author":"Fihn","year":"2014","journal-title":"Health Aff (Millwood)"},{"key":"coi260022r37","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/1478-7954-4-2","article-title":"Accuracy and completeness of mortality data in the Department of Veterans Affairs.","volume":"4","author":"Sohn","year":"2006","journal-title":"Popul Health Metr"},{"issue":"10","key":"coi260022r38","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.22531","article-title":"Assessment of rates of suicide risk screening and prevalence of positive screening results among US Veterans after implementation of the Veterans Affairs suicide risk identification strategy.","volume":"3","author":"Bahraini","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"6","key":"coi260022r39","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1177\/0033354916670133","article-title":"VA Suicide Prevention Applications Network: a national health care system-based suicide event tracking system.","volume":"131","author":"Hoffmire","year":"2016","journal-title":"Public Health Rep"},{"issue":"6","key":"coi260022r41","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1080\/03610910902859574","article-title":"Using the standardized difference to compare the prevalence of a binary variable between two groups in observational research.","volume":"38","author":"Austin","year":"2009","journal-title":"Commun Stat Simul Comput"},{"issue":"25","key":"coi260022r42","doi-asserted-by":"publisher","first-page":"3083","DOI":"10.1002\/sim.3697","article-title":"Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples.","volume":"28","author":"Austin","year":"2009","journal-title":"Stat Med"},{"issue":"2","key":"coi260022r43","doi-asserted-by":"publisher","first-page":"524","DOI":"10.2307\/2532940","article-title":"Applying Cox regression to competing risks.","volume":"51","author":"Lunn","year":"1995","journal-title":"Biometrics"},{"issue":"8","key":"coi260022r44","doi-asserted-by":"publisher","first-page":"1257","DOI":"10.1093\/gerona\/gly232","article-title":"The burden of frailty among U.S. Veterans and its association with mortality, 2002-2012.","volume":"74","author":"Orkaby","year":"2019","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"1","key":"coi260022r45","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1093\/bja\/aen103","article-title":"Assessment of pain.","volume":"101","author":"Breivik","year":"2008","journal-title":"Br J Anaesth"},{"key":"coi260022r46","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2025.119813","article-title":"Suicide rates and methods among veteran cancer survivors within the Veterans Health Administration (VHA), 2010-2020.","volume":"390","author":"Kittel","year":"2025","journal-title":"J Affect Disord"},{"issue":"20","key":"coi260022r47","doi-asserted-by":"publisher","first-page":"6563","DOI":"10.3390\/jcm12206563","article-title":"Suicide among cancer patients: current knowledge and directions for observational research.","volume":"12","author":"Grobman","year":"2023","journal-title":"J Clin Med"},{"key":"coi260022r48","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1016\/j.jad.2020.07.082","article-title":"Incidence of suicide death in patients with cancer: a systematic review and meta-analysis.","volume":"276","author":"Du","year":"2020","journal-title":"J Affect Disord"},{"issue":"11","key":"coi260022r49","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1513\/AnnalsATS.201805-299RL","article-title":"Incidence of suicide and association with palliative care among patients with advanced lung cancer.","volume":"15","author":"Sullivan","year":"2018","journal-title":"Ann Am Thorac Soc"},{"key":"coi260022r50","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.jpsychires.2022.07.048","article-title":"What distinguishes high and low-lethality suicide attempts in older adults? A systematic review and meta-analysis.","volume":"154","author":"Barker","year":"2022","journal-title":"J Psychiatr Res"},{"issue":"4","key":"coi260022r51","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1136\/ebmental-2022-300549","article-title":"Risk factors for suicide in adults: systematic review and meta-analysis of psychological autopsy studies.","volume":"25","author":"Favril","year":"2022","journal-title":"Evid Based Ment Health"},{"issue":"1","key":"coi260022r52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1943-278X.1998.tb00622.x","article-title":"The gender paradox in suicide.","volume":"28","author":"Canetto","year":"1998","journal-title":"Suicide Life Threat Behav"},{"issue":"3","key":"coi260022r54","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1037\/cps0000085","article-title":"Attempted suicide in American Indian and Alaska Native populations: a systematic review of research on protective factors.","volume":"29","author":"Wiglesworth","year":"2022","journal-title":"Clin Psychol (New York)"},{"issue":"8","key":"coi260022r55","first-page":"201","article-title":"Suicide trends among persons aged 10-24 years\u2013United States, 1994-2012.","volume":"64","author":"Sullivan","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"2","key":"coi260022r56","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1007\/s10900-024-01411-z","article-title":"Suicidal thoughts and behaviors in American Indian and Alaska Native adolescents.","volume":"50","author":"Price","year":"2025","journal-title":"J Community Health"},{"issue":"4","key":"coi260022r57","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0124341","article-title":"Leading causes of death among Asian American subgroups (2003-2011).","volume":"10","author":"Hastings","year":"2015","journal-title":"PLoS One"},{"key":"coi260022r58","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.xjon.2024.04.010","article-title":"Identifying Asian American lung cancer disparities: a novel analytic approach.","volume":"20","author":"Gu","year":"2024","journal-title":"JTCVS Open"},{"key":"coi260022r59","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.annepidem.2023.02.006","article-title":"Early onset of nasopharyngeal cancer in Asian\/Pacific Islander Americans revealed by age-specific analysis.","volume":"80","author":"Lee","year":"2023","journal-title":"Ann Epidemiol"},{"issue":"12","key":"coi260022r60","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1097\/JTO.0b013e31818ddff7","article-title":"Epidemiology of non-small cell lung cancer in Asian Americans: incidence patterns among six subgroups by nativity.","volume":"3","author":"Raz","year":"2008","journal-title":"J Thorac Oncol"},{"issue":"12","key":"coi260022r61","doi-asserted-by":"publisher","first-page":"2342","DOI":"10.1017\/S0033291720004250","article-title":"Suicidal\/self-harm behaviors among cancer patients: a population-based competing risk analysis.","volume":"52","author":"Men","year":"2022","journal-title":"Psychol Med"},{"issue":"8","key":"coi260022r62","doi-asserted-by":"publisher","first-page":"2165","DOI":"10.1016\/j.socscimed.2006.05.017","article-title":"The Black-White suicide paradox: possible effects of misclassification.","volume":"63","author":"Rockett","year":"2006","journal-title":"Soc Sci Med"},{"issue":"5","key":"coi260022r63","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1080\/07481180701244553","article-title":"A re-examination of cultural factors that mitigate risk and promote resilience in relation to African American suicide: a review of the literature and recommendations for future research.","volume":"31","author":"Utsey","year":"2007","journal-title":"Death Stud"},{"key":"coi260022r64","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.955008","article-title":"Three leading suicide methods in the United States, 2017-2019: associations with decedents\u2019 demographic and clinical characteristics.","volume":"10","author":"Choi","year":"2022","journal-title":"Front Public Health"},{"issue":"6","key":"coi260022r65","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0156322","article-title":"Meta-analysis of longitudinal cohort studies of suicide risk assessment among psychiatric patients: heterogeneity in results and lack of improvement over time.","volume":"11","author":"Large","year":"2016","journal-title":"PLoS One"},{"issue":"2","key":"coi260022r66","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2018.88","article-title":"Association between suicidal ideation and suicide: meta-analyses of odds ratios, sensitivity, specificity and positive predictive value.","volume":"5","author":"McHugh","year":"2019","journal-title":"BJPsych Open"},{"key":"coi260022r67","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/3289521","article-title":"Stress and quality of life of patients with cancer: the mediating role of mindfulness.","volume":"2020","author":"Dehghan","year":"2020","journal-title":"J Oncol"},{"issue":"11","key":"coi260022r68","doi-asserted-by":"publisher","first-page":"2577","DOI":"10.1002\/cncr.23448","article-title":"Physical and psychological long-term and late effects of cancer.","volume":"112","author":"Stein","year":"2008","journal-title":"Cancer"},{"issue":"2","key":"coi260022r69","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1111\/acps.13773","article-title":"Impact of early intervention for early psychosis on suicidal behavior\u2014a meta-analysis.","volume":"151","author":"Tahmazov","year":"2025","journal-title":"Acta Psychiatr Scand"},{"issue":"12","key":"coi260022r70","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1016\/S2215-0366(24)00316-X","article-title":"Psychological interventions to prevent the onset of major depression in adults: a systematic review and individual participant data meta-analysis.","volume":"11","author":"Buntrock","year":"2024","journal-title":"Lancet Psychiatry"},{"issue":"1","key":"coi260022r71","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1038\/s41467-018-08170-1","article-title":"Suicide among cancer patients.","volume":"10","author":"Zaorsky","year":"2019","journal-title":"Nat Commun"},{"issue":"11","key":"coi260022r72","doi-asserted-by":"publisher","first-page":"1864","DOI":"10.1002\/cncr.29274","article-title":"Factors associated with suicide in patients with genitourinary malignancies.","volume":"121","author":"Klaassen","year":"2015","journal-title":"Cancer"},{"issue":"7","key":"coi260022r73","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1002\/pon.5054","article-title":"Quality of life versus length of life considerations in cancer patients: a systematic literature review.","volume":"28","author":"Shrestha","year":"2019","journal-title":"Psychooncology"},{"issue":"15","key":"coi260022r74","doi-asserted-by":"publisher","first-page":"3534","DOI":"10.1002\/cncr.32961","article-title":"Importance of quality-of-life priorities and preferences surrounding treatment decision making in patients with cancer and oncology clinicians.","volume":"126","author":"Williams","year":"2020","journal-title":"Cancer"},{"issue":"3","key":"coi260022r75","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1007\/s11764-013-0272-z","article-title":"Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies.","volume":"7","author":"Simard","year":"2013","journal-title":"J Cancer Surviv"},{"issue":"5","key":"coi260022r76","doi-asserted-by":"publisher","first-page":"4547","DOI":"10.1007\/s00520-022-06872-3","article-title":"Health-related quality of life among cancer patients and survivors and its relationship with current employment status.","volume":"30","author":"Kim","year":"2022","journal-title":"Support Care Cancer"},{"issue":"1","key":"coi260022r77","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkaa123","article-title":"Factors associated with health-related quality of life among cancer survivors in the United States.","volume":"5","author":"Han","year":"2021","journal-title":"J Natl Cancer Inst Cancer Spectr"},{"issue":"2","key":"coi260022r78","doi-asserted-by":"publisher","first-page":"150","DOI":"10.14740\/wjon1541","article-title":"Quality of life impacts following surgery for advanced head and neck cancer.","volume":"14","author":"Douglas","year":"2023","journal-title":"World J Oncol"},{"issue":"3","key":"coi260022r79","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1001\/jamaoncol.2022.6549","article-title":"Incidence, timing, and factors associated with suicide among patients undergoing surgery for cancer in the US.","volume":"9","author":"Potter","year":"2023","journal-title":"JAMA Oncol"},{"issue":"13","key":"coi260022r80","doi-asserted-by":"publisher","first-page":"2455","DOI":"10.1002\/cncr.34220","article-title":"Financial toxicity impact on younger versus older adults with cancer in the setting of care delivery.","volume":"128","author":"Corrigan","year":"2022","journal-title":"Cancer"},{"issue":"5","key":"coi260022r81","doi-asserted-by":"publisher","first-page":"390","DOI":"10.6004\/jadpro.2023.14.5.4","article-title":"Quality of life in adult cancer patients with underage children: an integrative review.","volume":"14","author":"Mota-George","year":"2023","journal-title":"J Adv Pract Oncol"},{"issue":"1","key":"coi260022r82","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1007\/s11060-019-03218-8","article-title":"Primary central nervous system tumor treatment and survival in the United States, 2004-2015.","volume":"144","author":"Garcia","year":"2019","journal-title":"J Neurooncol"},{"issue":"3","key":"coi260022r83","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1038\/nrclinonc.2015.201","article-title":"Integrating palliative care into the trajectory of cancer care.","volume":"13","author":"Hui","year":"2016","journal-title":"Nat Rev Clin Oncol"},{"issue":"18","key":"coi260022r84","doi-asserted-by":"publisher","first-page":"3426","DOI":"10.1200\/JCO.23.00293","article-title":"Management of anxiety and depression in adult survivors of cancer: ASCO guideline update.","volume":"41","author":"Andersen","year":"2023","journal-title":"J Clin Oncol"},{"issue":"4","key":"coi260022r85","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.1007\/s11764-024-01602-6","article-title":"Developing national cancer survivorship standards to inform quality of care in the United States using a consensus approach.","volume":"18","author":"Mollica","year":"2024","journal-title":"J Cancer Surviv"},{"issue":"8","key":"coi260022r86","doi-asserted-by":"publisher","first-page":"792","DOI":"10.6004\/jnccn.2023.0041","article-title":"NCCN Guidelines\u00ae insights: survivorship, version 1.2023.","volume":"21","author":"Sanft","year":"2023","journal-title":"J Natl Compr Canc Netw"},{"issue":"5","key":"coi260022r87","doi-asserted-by":"publisher","first-page":"461","DOI":"10.6004\/jadpro.2019.10.5.4","article-title":"The integration of survivorship care planning at a comprehensive cancer center.","volume":"10","author":"McGrath","year":"2019","journal-title":"J Adv Pract Oncol"},{"key":"coi260022r88","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2022.103728","article-title":"Unmet supportive care needs of people with advanced cancer and their caregivers: a systematic scoping review.","volume":"176","author":"Hart","year":"2022","journal-title":"Crit Rev Oncol Hematol"},{"key":"coi260022r90","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.jad.2021.12.054","article-title":"The lethality of suicide methods: a systematic review and meta-analysis.","volume":"300","author":"Cai","year":"2022","journal-title":"J Affect Disord"},{"issue":"3","key":"coi260022r91","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1080\/13811118.2024.2420983","article-title":"Firearm availability reduces the stability of suicidal ideation: results from an ecological momentary assessment study.","volume":"29","author":"Bryan","year":"2025","journal-title":"Arch Suicide Res"},{"key":"coi260022r92","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.569069","article-title":"Addressing suicide in the veteran population: engaging a public health approach.","volume":"11","author":"Carroll","year":"2020","journal-title":"Front Psychiatry"},{"issue":"4","key":"coi260022r93","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.9995","article-title":"Social Vulnerability and risk of suicide in US adults, 2016-2020.","volume":"6","author":"Liu","year":"2023","journal-title":"JAMA Netw Open"},{"key":"coi260022r53","volume-title":"Epidemiology in Military and Veteran Populations: Proceedings of the Second Biennial Conference","author":"Page","year":"1991"},{"key":"coi260022r1","unstructured":"Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: results from the 2022 National Survey on Drug Use and Health. Center for Behavioral Health Statistics and Quality. Published 2023. Accessed April 30, 2026. https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/reports\/rpt42731\/2022-nsduh-nnr.pdf"},{"key":"coi260022r2","unstructured":"World Health Organization. Suicide worldwide in 2021: global health estimates. Published May 23, 2025. Accessed April 30, 2026. https:\/\/www.who.int\/publications\/i\/item\/9789240110069"},{"key":"coi260022r3","unstructured":"Centers for Disease Control and Prevention. Suicide data and statistics. Published March 26, 2025. Accessed April 30, 2026. https:\/\/www.cdc.gov\/suicide\/facts\/data.html"},{"key":"coi260022r33","unstructured":"North American Association of Central Cancer Registries. The data standards and data dictionary. Accessed April 30, 2026. https:\/\/apps.naaccr.org\/data-dictionary\/"},{"key":"coi260022r35","unstructured":"Compassion and Choices. Medical aid in dying utilization report. Updated February 12, 2026. Accessed April 30, 2026. https:\/\/compassionandchoices.org\/resource\/medical-aid-in-dying-utilization-report\/"},{"key":"coi260022r40","unstructured":"Crosby? A, Ortega? L, Melanson? C. Self-directed violence surveillance: uniform definitions and recommended data elements. Centers for Disease Control and Prevention. Published February 1, 2011. Accessed April 30, 2026. https:\/\/stacks.cdc.gov\/view\/cdc\/11997"},{"key":"coi260022r89","unstructured":"US Department of Veteran Affairs. National veteran suicide prevention annual report. Published November 2023. Accessed April 30, 2026. https:\/\/www.mentalhealth.va.gov\/docs\/data-sheets\/2023\/2023-National-Veteran-Suicide-Prevention-Annual-Report-FINAL-508.pdf"}],"container-title":["JAMA Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/articlepdf\/2849593\/jamaoncology_sullivan_2026_oi_260022_1784081558.692.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T15:00:54Z","timestamp":1784214054000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2849593"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":93,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoncol.2026.1459","relation":{},"ISSN":["2374-2437"],"issn-type":[{"value":"2374-2437","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,1]]}}}