Suicidal ideation in patients with cancer: A systematic review of prevalence, risk factors, intervention and assessment

Abstract

ObjectivesSuicidal ideation (SI) underlies risk of death by suicide. It is well established that patients with cancer are at increased risk of death by suicide. Therefore, understanding SI in patients with cancer is critically important. The goal of this systematic review was to investigate the prevalence, risk factors, intervention, and assessment of SI in patients with cancer.MethodsThis systematic review was registered with the PROSPERO database (CRD42018115405) and was guided by the PRISMA statement. We searched Medline, PsycInfo, Embase, CINAHL, the Cochrane Database of Systematic Reviews, and Cochrane Central. Two reviewers independently screened abstracts and assessed for quality assurance using a revised Newcastle-Ottawa Scale.ResultsWe identified 439 studies to screen for eligibility. Eligible studies included adults with cancer diagnoses and listed SI as an outcome. Ultimately, 44 studies were included in the analyses. Prevalence of SI ranged greatly from 0.7% to 46.3%. Single items drawn from validated measures were the most frequent method of assessing SI (n = 20, 45.5%); additional methods included validated measures and psychological interviews. Commonly identified risk factors for SI included age, sex, and disease/treatment-related characteristics, as well as psychological constructs including depression, anxiety, hopelessness, existential distress, and social support.Significance of ResultsAssessment of SI in patients with cancer is the concern of researchers worldwide. Prevalence of SI varied with study population and was likely influenced by the method of assessment. Psychological distress consistently predicted SI. Increasing awareness of demographic, clinical, and psychological associations is critical for risk assessment and intervention development.

Suicidal Ideation in Newly-Diagnosed Chinese Cancer Patients

“…A recent review reported a wider range of percentages between 0.8 and 71.4% of suicidal ideation in cancer patients, compared to a range of 1. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19].8% in the general population (11). Another review, involving 44 relevant studies indicated that the prevalence of suicidal ideation ranged from 0.8 to 46.2% among cancer patients; with lowest figures being reported by an American study while the highest percentage was reported in Chinese samples (12).…”

“…For example, advanced cancer stage, impaired physical functioning, cancer pain, depression, anxiety, hopelessness, existential distress, and limited social support were consistently proven to be risk factors for suicidal ideation in cancer patients (11). Gender, age, race, and treatment type were also reported to be associated with suicidal ideation, however, the findings have been often conflictive (12). A recent Chinese study reported that depression, anxiety, metastatic cancer, poor performance status, surgery, and palliative care were significantly associated with suicidal ideation, whereas, compared to demographic or clinical factors, psychological characteristics were more vital in predicting patient's suicidal ideation (13).…”

The significance of the Interpersonal‐Psychological Theory of Suicide in an oncological context—A scoping review

“…The selection of the articles took place in a multi‐step process, following the example of Kolva et al. (2019). Firstly, the researchers (JS, JCC) independently reviewed titles and abstracts of the retrieved literature fully blinded, labelling them with “Yes,” “No” or “Maybe” for a full‐text review, based on the inclusion criteria.…”

“…Previous systematic reviews in this field focused on the broad topic of suicide, researching incidence rates for suicide in patients with cancer, risk factors or potential screening tools (Anguiano, Mayer, Piven, & Rosenstein, 2012; Robson et al., 2010; Spoletini et al., 2011). SI in individuals with cancer has been reviewed as well (Kolva, Hoffecker, & Cox‐Martin, 2019).…”

Newly diagnosed patients with advanced non-small cell lung cancer: A clinical description of those with moderate to severe depressive symptoms

“…Even when patients are screened "positive," the complete picture of difficulties and impairments that are likely to ac-company moderate to severe depressive symptoms is not clear. Research with other cancer types would suggest that there are cooccurring stressors and cognitive and behavioral disruptors, and they too may impede cancer patients' coping with the diagnosis and decision-making as do depressive symptoms [29][30][31][32].…”