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Damien Urban, MBBS, BMedSc; Aparna Rao, MBBS; Mathias Bressel, MSc; Dina Neiger, PhD; Benjamin Solomon, MBBS, PhD; Linda Mileshkin, MBBS, MD, MBioeth (Mon)
Author and Funding Information

From the Department of Medical Oncology (Drs Urban, Rao, Solomon, and Mileshkin), and the Centre for Biostatistics and Clinical Trials (Mr Bressel and Dr Neiger), Peter MacCallum Cancer Centre.

Correspondence to: Damien Urban, MBBS, BMedSc, Department of Medical Oncology, Peter MacCallum Cancer Centre, 10 St. Andrews Place, East Melbourne, VIC, 3002, Australia; e-mail: damien.urban@petermac.org


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(3):666. doi:10.1378/chest.13-2751
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To the Editor:

We thank Drs Gnanavel and Robert for their interest in our recent article describing suicide in patients with lung cancer based on the Surveillance, Epidemiology, and End Results database.1 We agree with their comment that a significant proportion of those who committed suicide may have suffered from a comorbid (pre-existing) depressive disorder or other psychiatric illnesses. However, as discussed in our article, there are limitations to the data available in the Surveillance, Epidemiology, and End Results database. In particular, comorbid psychiatric diagnoses are not recorded.

Regarding the concept of performing psychologic autopsies in all of these cases, although this methodology would certainly expand our understanding of the causality of suicide in each case, the retrospective nature of our study and use of a deidentified registry data source make such a task near impossible. We certainly agree with the comments regarding the need for oncologists and pulmonologists to promptly identify psychiatric symptoms, which may lead to timely and early referral to psychiatrists. Indeed, our motivation for conducting this research was to highlight the importance of this issue within the field of thoracic oncology, and we hope to encourage others to explore options of prospective screening for psychologic distress and indicators of suicidal ideation. Ultimately, we hope that such efforts may lead to a reduction in this preventable cause of death in patients diagnosed with lung cancer.

References

Urban D, Rao A, Bressel M, Neiger D, Solomon B, Mileshkin L. Suicide in lung cancer: who is at risk? Chest. 2013;144(4):1245-1252. [CrossRef] [PubMed]
 

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References

Urban D, Rao A, Bressel M, Neiger D, Solomon B, Mileshkin L. Suicide in lung cancer: who is at risk? Chest. 2013;144(4):1245-1252. [CrossRef] [PubMed]
 
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