Cancer diagnosis and suicide outcomes: Umbrella review and methodological considerations.
J Affect Disord
; 295: 1201-1214, 2021 12 01.
Article
in En
| MEDLINE
| ID: mdl-34706434
ABSTRACT
BACKGROUND:
Suicide outcomes in cancer patients represent a major public health concern. We performed an umbrella review (UR) including all meta-analyses (MAs) and systematic reviews (SRs) published on the association between cancer and suicide outcomes.METHODS:
Eligible studies were searched in the main scientific databases up to January 23rd, 2021. Eligible MAs/SRs focused on all suicide phenotypes among cancer patients. Evidence of the association was extracted; the credibility and quality of the included studies were evaluated using ad-hoc tools, including "A MeaSurement Tool to Assess systematic Reviews-2-Revised" (AMSTAR-2-R).RESULTS:
Six MAs and 6 SRs were included. The standardized mortality ratio of suicide in cancer patients was 1.5 to 1.7-fold higher than in the general population. Risk factors for suicide outcomes among cancer patients were male sex and older age, a cancer diagnosis within the prior year, and some specific cancer sites. Among 107 associations, 90 (84.1%) were supported by high credibility of evidence (class II). However, all studies reported a large heterogeneity (I2> 50%) and the majority of them reported considerable heterogeneity (I2> 75%). All MAs used random-effects measures. All MAs but one assessed publication bias and only one disclosed it. The majority of MAs/SRs showed critically low quality based on AMSTAR-2-R.LIMITATIONS:
We could not perform additional analyses due to the limited number of MAs.CONCLUSIONS:
This UR underlines the inflated risk for suicide among cancer patients. Upcoming, well-designed studies are needed to account for a broader set of variables. Several methodological issues likewise warrant attention.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Suicide
/
Neoplasms
Type of study:
Diagnostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limits:
Aged
/
Humans
/
Male
Language:
En
Journal:
J Affect Disord
Year:
2021
Document type:
Article