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.

Cancer diagnosis and suicide outcomes: Umbrella review and methodological considerations / R. Calati, C. Filipponi, W. Mansi, D. Casu, G. Peviani, G. Gentile, S. Tambuzzi, R. Zoja, M. Fornaro, J. Lopez-Castroman, F. Madeddu. - In: JOURNAL OF AFFECTIVE DISORDERS. - ISSN 0165-0327. - 295(2021), pp. 1201-1214. [10.1016/j.jad.2021.08.131]

Cancer diagnosis and suicide outcomes: Umbrella review and methodological considerations

C. Filipponi;G. Gentile;S. Tambuzzi;R. Zoja;
2021

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.
Cancer; Meta-analysis; Oncology; Suicidal behaviors; Suicide; Systematic review; Umbrella review
Settore MED/43 - Medicina Legale
Settore MED/06 - Oncologia Medica
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/869964
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