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Research Article: Development and validation of a nomogram for predicting suicide risk factors in thyroid cancer patients following diagnosis: a population-based retrospective study

Date Published: 2025-09-30

Abstract:
To develop and validate a user-oriented nomogram of suicide risk in thyroid cancer patients to enable clinicians to identify and intervene in a timely manner with high-risk subgroups. This was a retrospective, population-based cohort study in which patients with thyroid cancer diagnosed from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2020 were include. Optimized features were screened by the least absolute shrinkage and selection operator (LASSO) regression model. Subsequently, we selected variables with nonzero coefficients, entered them into a Cox proportional hazards regression model and constructed a visualized nomogram model predicting suicide. We implemented receiver operating characteristic curves (ROC), calibration curves, decision curve analysis (DCA), and internal validation to assess the discrimination, calibration, clinical applicability, and generalizability of the nomogram. To our knowledge, this is the first nomogram specifically designed for thyroid cancer patients, integrating histopathological, therapeutic, and socioeconomic predictors. Furthermore, the calibration curves for this nomogram fit well with the diagonal, and the C-indexes for the training and testing sets were 0.760 and 0.724, respectively, and the decision curve analysis indicated clinical benefit. This study successfully identified risk factors for suicide in patients with thyroid cancer and developed a nomogram that provides patients with an individualized, quantifiable assessment of suicide risk and assists clinicians in identifying and intervening in potential suicides.

Introduction:
With advances in diagnostic imaging and surveillance, the detection rate of thyroid cancer continues to increase. According to the International Agency for Research on Cancer of the World Health Organization, the incidence of thyroid cancer is the ninth highest in the world ( 1 , 2 ). In addition, thyroid cancer is the most common malignant tumor among women in the United States ( 3 ). Thyroid cancer patients have a cumbersome financial burden, and the bankruptcy rate among survivors is higher than for other…

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