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. 2022 Feb;7(1):100349.
doi: 10.1016/j.esmoop.2021.100349. Epub 2022 Jan 20.

Assisted suicide in patients with cancer

G Montagna  1 , C Junker  2 , C Elfgen  3 , A R Schneeberger  4 , U Güth  5
Affiliations

Assisted suicide in patients with cancer

G Montagna et al. ESMO Open. 2022 Feb.

Abstract

Background: There are limited data on the long-term development and trends of assisted suicide (AS) among cancer patients.

Patients and methods: Using data of the Swiss Federal Statistical Office, we analyzed AS trends over an 18-year period (1999-2016; total number of cases = 6553).

Results: Among patients who underwent AS, cancer was the most common underlying disease (n = 2704, 41.3% of all AS cases). The most common cancer types were lung (14.0% of cancer-related AS cases), breast (11.0%) and prostate (10.1%). There was a slight preponderance of men compared with women (51.5% versus 48.5%). The proportion of AS cases within cancer types did not change over time. The ratio of cancer-related AS cases in relationship with all cancer-related deaths increased from 0.3% at the beginning of the study period (1999-2003) to 2.1% from 2014 to 2016 (change of age-standardized rates for men: +488%; for women: +417%). At the end of the study period (2014-2016), there were only minor differences between cancer-specific ratios, highest and lowest range: 1.1% (liver cancer) and 2.8% (breast, esophageal and lip/oral cavity/oropharynx cancer). Individuals who underwent AS because of cancer were considerably younger than those who choose AS on account of other diseases (73 years versus 80 years). The median age of people with cancer-related AS was similar to that of all cancer-related deaths (74 years): for women, the median age of cancer-related AS was 72, whereas for men it was 75. The median age at which AS took place increased over time.

Conclusions: During the study period, the proportion of people who chose cancer-related AS has approximately sextupled. However, AS among cancer patients remains rare and represents only ∼2% of all cancer-related deaths.

Keywords: Switzerland; assisted dying; assisted suicide; cancer; end-of-life decision making.

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Conflict of interest statement

Disclosure The authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1
Development of the number of assisted suicide cases in Switzerland from 1999 to 2016.
Figure 2
Figure 2
Cancer-related assisted suicide between 1999 and 2016 (n = 2704): distribution of different types of cancer. CNS, central nervous system; L&H, lymphatic and hematopoietic neoplasms; L/OC/O, lip/oral cavity/oropharynx.
Figure 3
Figure 3
Development over time of the proportion of cancer-related assisted suicides to cancer-related deaths. Reported are the nine most frequent cancer types of cancer. L&H neoplasms, lymphatic and hematopoietic neoplasms.
See this image and copyright information in PMC

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