精神疾病（MI）和自杀意向（SI）通常与癌症诊断有关。我们旨在确定胃肠道癌症患者中MI和SI的发病率，并确定与SI相关的预测因素。本研究从SEER-Medicare数据库中筛选出2004年至2016年诊断为胃、肝、胰腺和结直肠癌的患者。从美国疾病控制与预防中心数据库中提取县级社会易感指数（SVI）。用多变量 Logistic 回归模型确定与 SI 相关的因素。在382,266 名患者中，有83,514（21.9%）人被诊断出患有MI。仅有1,410人（0.4%）经历了SI，并有359人（0.1%）自杀。有趣的是，胰腺癌患者中的 SI 最不可能发生（参考值：肝癌； 几率比 [OR] 0.67，95% 置信区间 [CI] 0.52-0.86；p=0.002），以及 III/IV 期疾病的患者（OR 0.59，95% CI 0.52-067；p<0.001）。相反，男性（OR 1.34，95% CI 1.19-1.50）、白人（OR 1.34，CI 1.13-1.59）和单身患者（OR 2.03，95% CI 1.81-2.28）成为 SI 风险更高的人群（所有 p <0.001）。此外，生活在相对富裕（低 SVI）的人群中的 SI 风险明显更高（OR 1.33，95% CI 1.14-1.54；p<0.001）。此外，生活在心理健康专业人员短缺的县的患者增加了发生SI的几率（OR 1.21，95% CI 1.04-1.40；p=0.012）。肿瘤科护理团队应将常规精神健康和 SI 筛查纳入胃肠道癌症患者的治疗，以及针对风险最高的患者进行自杀预防。© 2023年。外科肿瘤学会。

Mental illness (MI) and suicidal ideation (SI) often are associated with a diagnosis of cancer. We sought to define the incidence of MI and SI among patients with gastrointestinal cancers, as well as ascertain the predictive factors associated with SI.Patients diagnosed between 2004 and 2016 with stomach, liver, pancreatic, and colorectal cancer were identified from the SEER-Medicare database. County-level social vulnerability index (SVI) was extracted from the Centers for Disease Control database. Multivariable logistic regression was used to identify factors associated with SI.Among 382,266 patients, 83,514 (21.9%) individuals had a diagnosis of MI. Only 1410 (0.4%) individuals experienced SI, and 359 (0.1%) committed suicide. Interestingly, SI was least likely among patients with pancreatic cancer (ref: hepatic cancer; odds ratio [OR] 0.67, 95% confidence interval [CI] 0.52-0.86; p = 0.002), as well as individuals with stage III/IV disease (OR 0.59, 95% CI 0.52-067; p < 0.001). In contrast, male (OR 1.34, 95% CI 1.19-1.50), White (OR 1.34, CI 1.13-1.59), and single (OR 2.03, 95% CI 1.81-2.28) patients were at higher odds of SI risk (all p < 0.001). Furthermore, individuals living in relative privilege (low SVI) had markedly higher risk of SI (OR 1.33, 95% CI 1.14-1.54; p < 0.001). Moreover, living in a county with a shortage of mental health professionals was associated with increased odds of developing SI (OR 1.21, 95% CI 1.04-1.40; p = 0.012).Oncology care teams should incorporate routine mental health and SI screening in the treatment of patients with gastrointestinal cancers, as well as target suicide prevention towards patients at highest risk.© 2023. Society of Surgical Oncology.