OHSU study: Veterans with cancer face ongoing suicide risk
Large, national study finds suicide attempt risk among veterans is highest after diagnosis, remains elevated for years; highlights need for continued mental health support
Oregon Health & Science University
Veterans diagnosed with cancer face a higher risk of suicide attempts — especially in the months following diagnosis — and that risk can persist for years, found a large, national study led by Oregon Health & Science University and the Veterans Health Administration.
The study, published in JAMA Oncology, analyzed nearly a decade of data from more than 292,000 veterans with cancer. It found that overwhelming distress tied to diagnosis, treatment and long-term effects of the disease continues to put many patients at risk well into survivorship.
“Our findings really show that suicide risk doesn’t end when treatment ends,” said Donald R. Sullivan, M.D., M.A., M.C.R., associate professor of medicine in the OHSU School of Medicine and lead author of the study. “For some patients, especially younger veterans and those with certain cancers, the risk remains elevated for years.”
Risk beyond diagnosis
Researchers examined both fatal and nonfatal suicide attempts, known collectively as suicidal self-directed violence, among veterans diagnosed with cancer between 2014 and 2023. Most previous studies have focused only on deaths by suicide, missing the far more common nonfatal attempts.
Of the 2,400 suicide-related events identified, nearly 90% were nonfatal attempts. Overall, veterans with cancer experienced suicide attempts at a rate of 203 per 100,000 — significantly higher than the general population.
The risk was highest in the first six months after diagnosis, but it remained persistently elevated for up to five years.
“A cancer diagnosis is often a profound shock,” Sullivan said. “Even cancers with good survival rates can trigger an immediate fear of death. That initial moment, combined with pain, treatment side effects, anxiety or depression, can be incredibly destabilizing.”
Overlooked groups
The study identified several groups with higher-than-average risk for suicide attempts: veterans who were younger than 45, women, those who were unmarried, and veterans who were American Indian or Alaska Native.
Certain cancer types also carried greater risk, including cancers of the brain and central nervous system, pancreas, head and neck, liver and thyroid.
“Younger veterans really stood out,” Sullivan said. “They may be dealing with careers, family responsibilities or financial stress on top of a cancer diagnosis. That combination can be overwhelming.”
Women veterans and those with thyroid cancer — often considered a more treatable disease — also experienced notably higher rates of nonfatal attempts, a finding Sullivan said underscores the importance of screening all cancer patients, not just those with poor prognoses.
Survivorship challenges
Veterans with chronic mental illness, high pain levels or severe frailty were also among those at highest risk. Prescription medications — including opioids — were the most common method used in nonfatal suicide attempts, while firearms accounted for most fatal attempts.
“These results reinforce the need for better support not just during treatment, but after treatment ends,” Sullivan said. “Survivorship often comes with lasting physical symptoms, emotional distress and fear of recurrence — and we don’t always do enough to address those challenges.”
The study also found that veterans who received palliative care — or specialized medical care for people with serious, complex or terminal illness — had lower rates of suicide-related events, suggesting early supportive services may help reduce risk.
“Every care provider can help veterans who are struggling with the burden of both cancer and suicidal ideation. This study provides important insights into how caregivers can provide critically needed mental health support to veterans,” said OHSU President Shereef Elnahal, M.D., M.B.A. “In my time as Under Secretary for Health in the VA, preventing veteran suicides was our top clinical priority, and it should continue to be a focal point for veteran care.”
Improving screening, support
Because the U.S. Department of Veterans Affairs, or VA, maintains a comprehensive suicide surveillance system, researchers were able to identify patterns that are invisible in most other health systems.
“This kind of data simply doesn’t exist for nonveterans,” Sullivan said. “But what we’re seeing here almost certainly applies beyond the VA.”
The authors say routine suicide risk screening should begin at diagnosis and continue through survivorship, tailored to individual risk factors such as age, cancer type, pain and mental health history.
“Cancer care can’t just focus on treating tumors,” Sullivan said. “We have to care for the whole person — their mental health, their quality of life and the existential distress that comes with serious illness.”
If you or someone you know is having a mental health crisis or suicidal thoughts, call the National Suicide Hotline at 9-8-8. You can also go to SpeakingOfSuicide.com/resources for additional resources.
This research was supported by Veterans Affairs (VA) Health Services Research and Development Small Award Initiative for Impact, the Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, and the National Center for Lung Cancer Screening, Washington. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs, the U.S. Government or any other funders.
Journal
JAMA Oncology
Method of Research
Data/statistical analysis
Subject of Research
People
Article Title
Longitudinal Risk for Suicidal Self-Directed Violence Among Veterans With Cancer
Article Publication Date
28-May-2026
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