Cancer diagnosis and suicide outcomes: Umbrella review and methodological considerations

JOURNAL OF AFFECTIVE DISORDERS

卷:295

Review

Calati, Raffaella^1,2  Filipponi, Chiara¹  Mansi, William¹  Casu, Diego¹  Peviani, Giulia¹  Gentile, Guendalina³  Tambuzzi, Stefano³  Zoja, Riccardo³  Fornaro, Michele⁴  Lopez-Castroman, Jorge^2,5,6,7  Madeddu, Fabio¹ 

[1] Univ Milano Bicocca, Dept Psychol, U6 Bldg,Room 3129,Piazza Ateneo Nuovo 1, I-20126 Milan, Italy

[2] Nimes Univ Hosp, Dept Psychiat, Nimes, France

[3] Univ Milan, Inst Forens Med, Dept Biomed Sci Hlth, Forens Histopathol & Microbiol Lab, Milan, Italy

[4] Univ Sch Med Federico II, Sect Psychiat, Dept Neurosci Reprod Sci & Dent, Naples, Italy

[5] CNRS, Inst Funct Genom, INSERM, Montpellier, France

[6] Univ Montpellier, Montpellier, France

[7] CIBERSAM, Madrid, Spain

关键词: Suicide;    Suicidal behaviors;    Cancer;    Oncology;    Umbrella review;    Systematic review;    Meta-analysis;   

DOI  :  10.1016/j.jad.2021.08.131

来源: Elsevier

【 摘 要 】

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 (I-2 > 50%) and the majority of them reported considerable heterogeneity (I-2 > 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.

【 授权许可】

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