Although suicide is the 10th leading cause of death in the United States, the incidence of suicidal death is higher among people with cancer than among the general population. Now, a new study published in the journal Cancer suggests that there is a greater risk of suicide following a cancer diagnosis, reports Wiley.

For their analysis, researchers gathered data from the Surveillance, Epidemiology, and End Results (SEER) Program, an authoritative source of information on cancer incidence and survival in the United States. The study, the largest of its kind, included 4,671,989 people with cancer diagnosed between 2000 and 2014.

Within one year of cancer diagnosis, 1,585 people committed suicide. Scientists found a two and half times higher risk among this population than is expected in the general population.

Suicide risk was highest after diagnoses of pancreatic and lung cancer followed by a colorectal cancer diagnosis. However, risk of suicidal death didn’t show a significant increase following breast or prostate cancer diagnoses.

“Our study highlights the fact that for some patients with cancer, their mortality will not be a direct result of the cancer itself, but rather because of the stress of dealing with it, culminating in suicide,” said the study’s co–senior author Hesham Hamoda, MD, MPH, of Boston’s Children’s Hospital and Harvard Medical School.

According to co–senior author Ahmad Alfaar, MBBCh, of Charité-Universitätsmedizin Berlin, “Awareness among providers to screen for suicide risk and refer to mental health services is important for mitigating such risk and saving lives, especially within the first six months after diagnosis.”

Experts conclude that such services must be integrated into cancer care early.\

Click here to learn how mental health screenings during and after cancer treatment are increasingly becoming the standard of care.