{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T15:48:00Z","timestamp":1786463280837,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess incidence, temporal trends, and risk factors for suicide among patients with HNC using Surveillance, Epidemiology, and End Results (SEER) data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 222,222 patients were diagnosed with HNC from the SEER 17 registries between 2012 and 2021. Suicide deaths were identified using the SEER cause\u2010of\u2010death category \u201csuicide and self\u2010inflicted injury.\u201d We calculated age\u2010, sex\u2010, and race\u2010adjusted suicide incidence rates and standardized mortality ratios relative to the US general population. Risk factors analyzed included demographic variables, tumor site, disease stage, treatment modality, and time since diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 298 suicides among patients with HNC over 1.9 million person\u2010years (33.53 per 100,000 person\u2010years; SMR, 1.90; 95% CI, 1.69\u20132.13). Suicide rates were highest among men (SMR, 2.23), unmarried individuals (SMR, 2.78), and patients with distant metastatic disease (SMR, 2.87). Site\u2010specific analysis showed elevated suicide risk for hypopharyngeal (SMR, 4.18) and laryngeal (SMR, 2.95) cancers. Radiation\u2010only treatment was associated with a higher suicide rate (SMR, 3.23), as was receiving no surgery or radiation (SMR, 5.39). Most suicides occurred within 5\u2009years of diagnosis, particularly among patients with oral cavity and oropharyngeal cancers (SMR, 3.09). In some cancers, elevated suicide risk persisted beyond 10\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While there was an observed reduction in SMR relative to earlier cohorts, this should be interpreted cautiously given rising general\u2010population suicide rates during the study period. High\u2010risk subgroups, including males, unmarried individuals, patients with cancer of the hypopharynx or larynx, and those receiving radiation alone or no definitive treatment, continue to face disproportionately elevated risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70816","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T13:40:01Z","timestamp":1786455601000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Updated Incidence of Suicide Among Patients With Head and Neck Cancer"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1688-3055","authenticated-orcid":false,"given":"Anthony M.","family":"Saad","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0310-6819","authenticated-orcid":false,"given":"David","family":"Herz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celina","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohini","family":"Bahethi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soly","family":"Baredes","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard Chan Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Rutgers New Jersey Medical School  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2015.2480"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.27529"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103026(21)00133\u20102"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.4317\/medoral.25878"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6251"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcpc1913473"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11356\u2010022\u201018798\u20108"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2024.3233"},{"issue":"38","key":"e_1_2_9_10_1","first-page":"61","article-title":"A Prospective Study to Evaluate the Impact of Cancer Directed Treatment on Quality of Life in Head and Neck Cancer Patients","volume":"1","author":"Parkar S.","year":"2022","journal-title":"Gulf Journal of Oncology"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.5114\/wo.2015.51420"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.128.2.181"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215113002478"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814557772"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.06.017"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.2310\/7070.2006.0011"},{"issue":"8","key":"e_1_2_9_17_1","first-page":"791","article-title":"Why Are Men Killing Themselves? 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