Suicidal Ideation, Suicide Attempts, and Suicide Mortality in Cancer: An Overview of Systematic Reviews with Meta-Analysis

Background: this overview of systematic reviews with meta-analysis summarized the epidemiology of suicide in cancer, mainly focused on prevalence, incidence, and risk. Methods: the CINAHL (via EBSCOhost), Embase, PsycINFO (via ProQuest), and PubMed databases were searched from inception to February 2024. AMSTAR 2 evaluated the methodological quality of reviews. The degree of overlap between reviews was calculated. Results: Twelve systematic reviews with meta-analysis were included. The prevalence of suicidal ideation in prostate cancer was 9.85% (95%CI 7.31-12.70%). The relative risk of suicidal ideation in prostate cancer was 2.01 (95%CI: 1.52-2.64) in comparison to controls without this type of cancer during the first 12 months after diagnosis. Furthermore, the risk of suicidal ideation was higher among individuals with bladder cancer in comparison to people without this clinical condition (HR 1.90, 95%CI 1.29-2.81). The crude suicide mortality rate per 100,000 person-years in prostate cancer was 47.1 per 100,000 person-years (95%CI 39.85-54.96). Incidence suicide death per 100,000 person-years was higher in sarcoma (60.99 per 100,000 person-years, 95%CI 17.37-214.19), esophagus (87.71 per 100,000 person-years, 95%CI 27.42-280.54), and pancreas (75.39 per 100,000 person-years, 95%CI 41.80-135.97). Finally, the standardized mortality ratio by suicide was higher in the pancreas (SMR 6.42, 95%CI 1.60-25.76), bone and cartilage (SMR 9.59, 95%CI 1.54-59.77), and mesothelioma (SMR 13.07, 95%CI 1.61-105.80). Conclusions: overall, meta-analyses underlined the relevance of suicide mortality in different cancer sites and geographical regions. Some meta-analyses also found suicidal ideation may be important in prostate or bladder cancer.