Little is known about the suicide risk among cancer patients in Asian country.

To identify the risk and correlates of suicide death among cancer patients in Taiwan.

To provide the references for policy-making of suicide prevention and information for clinicians and care-givers.

We conducted a retrospective cohort study of cancer patients in Taiwan from 1985 to 2007 by linking two national-wide databases of the Taiwan Cancer Registry and the National Mortality File. Standardized mortality ratios (SMR) and 95% confidence intervals (CIs) were estimated based on the general population rates of suicide stratified by age, sex, and calendar year.

Among 930,230 registry cancer patients observed for 4,376,574 person-years, 2614 suicides were ascertained. Individuals with diagnosis of cancer had significantly higher risk to die by suicide (Man SMR=2.46, 95% CI=2.35–2.58; Woman SMR=2.12, 95% CI=1.98–2.28). Patients with cancers of head/neck, esophagus, and lung had additional higher risk to commit suicide. The risk of suicide elevated soon within first 3 months after cancer was diagnosed (Man SMR = 6.57, 95% CI=5.82–7.41; Woman SMR=5.83, 95% CI=4.71–7.21).

Compared with general population, cancer patients had significantly higher risk to commit suicide in Taiwan. In addition to the prevention works focused on common risk factors of suicide death, clinicians and caretakers should pay special attention to patients with certain types of cancers and to those who were newly diagnosed to have cancers.