Abstract C091: Health disparities by sex and cancer type among suicide decedents

Abstract Background: Suicide risk and health disparities intersect across both sex and cancer type through a combination of biological, psychosocial, and health-system factors. Sex-specific malignancies (e.g., breast and cervical, uterine cancer in women; prostate and testicular cancer in men) may compound psychosocial challenges, body-image disturbance, identity shifts, and social isolation, thereby deepening inequities in mental health outcomes. This study evaluates disparities in suicidal ideation (SI), self-harm (SH), and suicide attempts (SA) among decedents with and without prior cancer, disaggregating by sex and by cancer type to uncover differential vulnerability. Methods: State-level data on 14,644 suicide decedents, ascertained by the Utah Office of the Medical Examiner, were analyzed using contingency analyses and Fisher’s exact tests. Suicidality was operationalized across three domains: SI, SH, and SA. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated to compare suicidality between decedents with and without cancer. Analyses were stratified by sex and by cancer type (sex-specific vs. non-sex-specific): sex-specific cancers included breast, cervical, and uterine cancers in women, and prostate and testicular cancers in men; non-sex-specific cancers comprised all other malignancies not involving reproductive organs. Results: Overall, cancer history was linked to markedly higher suicidality, disproportionately so in women (OR=7.90; 95% CI 4.90–12.73) versus men (OR=2.07; 95% CI 1.48–2.89). Among women with sex-specific cancers, 89% exhibited some form of suicidality. SI (OR=3.01; 95% CI 2.17–4.17), SA (OR=4.75; 95% CI 3.52–6.41), and SH (OR=6.05; 95% CI 4.49–8.15), compared to 51% of cancer-free decedents. In contrast, men with non-sex-specific cancers (notably lung and gastrointestinal) showed elevated SI (OR=1.50; 95% CI 1.19–1.88) and SA (OR=1.31; 95% CI 1.08–1.59), but no increase in SH. Men with prostate or testicular cancer did not differ from non-cancer decedents. Conclusions: These findings reveal pronounced sex and cancer-type specific disparities in suicidality among decedents with a prior cancer diagnosis. Women who experienced sex-specific cancers had a substantially higher mental health burden across all suicidality domains, underscoring an urgent need for targeted mental-health interventions in this group. In men, elevated risk was confined to non-sex-specific cancers such as colon and other cancers characterized by high symptom burden and poor prognosis, suggesting distinct functional and existential drivers. Addressing these disparities necessitates sex and cancer specific tailored mental health and suicide prevention strategies within oncology care pathways, to mitigate inequities as cancer survivorship continues to improve. Citation Format: Brandy M. Byrwa-Hill, Eric T. Monson, Emily DiBlasi, Hilary Coon, Danli Chen, Michael Staley, Amanda V. Bakian. Health disparities by sex and cancer type among suicide decedents [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr C091.