Sex-Specific Factors Associated with Suicidal Ideation among Patients with Cancer in Korea: A Population-Based Study

Objective: Given the higher rate of suicide among patients with cancer, which exhibits different patterns and rates according to sex, this study aimed to examine the prevalence of suicidal ideation in Korean patients with cancer and to explore sex-specific factors with suicidal ideation. Methods: This cross-sectional study analyzed a nationally representative sample derived from the 2020 Korea Health Panel Survey, which encompassed 14,741 participants surveyed in 2019 and 2020. A weighted sample of cancer patients who reported on their suicidal ideation was analyzed (N = 511). Multinomial logistic regression analysis was employed to assess the relationships between sex-specific factors and suicidal ideation. Results: Among cancer patients, 8.6% had suicidal ideation, which was slightly higher in females (8.7%) than males (8.5%) (p < 0.001). Cancer patients’ suicidal ideation factors varied by sex: males’ suicidal ideation was associated with older age, lower education, unemployment, being unmarried, bed-ridden, underweight, comorbidities, and better self-rated health; females’ suicidal ideation was associated with younger age, being married, employed, higher body mass index, and worse self-rated health (all p-values < 0.001). Pain/discomfort and depression were more strongly associated with male cancer patients, while anxiety was more strongly related to female cancer patients; however, all these factors were linked to increased suicidal ideation in both groups. Conclusion: Suicidal ideation among male cancer patients increased with low financial status, whereas suicidal ideation among female cancer patients was influenced by poor health status and social burden. Given that the factors associated with suicidal ideation differ by sex, healthcare providers need to consider sex-specific differences when assessing suicide risk among patients with cancer, particularly those experiencing pain, depression, or anxiety. Further research is needed to better understand these sex-based differences and their implications for cancer care.