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An Ottawa doctor has raised a red flag on the suicide risk among cancer patients.

In a research paper published on-line this week in the Annals of Oncology, Dr. Wayne Kendal analyzed 1.3 million cancer cases in the United States and found that 19 out of every 1,000 male cancer patients and four out of every 1,000 female cancer patients committed suicide.

At about 24 suicides per 100,000 among cancer patients per year, the rate was between two and two-and-a-half times that of the general population. Overall, the U.S. population records 10.6 suicides per 100,000 people, including cancer patients.

The nearly fivefold predominance of suicides among male-to-female cancer patients reflects a similar pattern in the general population.

Dr. Kendal, a radiation oncologist at the Ottawa Hospital Regional Cancer Centre, said the risk of suicide varied according to a number of factors, including gender, prognosis, the stage of the disease, the type of cancer and the patient's family situation.

“We must get the message out to physicians, nurses and social workers that they should be aware of the potential for suicide in their cancer patients and that maybe, by giving people in need, and their families, more support and providing better symptom control we might be able to foster the desire to continue living,” Dr. Kendal said.

Looking at men and women combined, cancer with the highest suicide rates were those of the lung and bronchus, bladder, head and neck, oesophagus and myeloma. Breast and liver cancer patients had the lowest rates.

When it was split according to sex, however, the results were different.

For women, suicide rates were similar despite where the disease hit, with the exception of those suffering colorectal and cervical cancer which had lower suicide rates.

Among men, the highest rates were for head and neck, liver cancer and myeloma.

Both sexes were more likely to commit suicide if their cancer had already spread from its primary site to distant organs, the study found.