1. Cancer diagnosis and suicide outcomes: Umbrella review and methodological considerations
- Author
-
Raffaella Calati, Guendalina Gentile, Riccardo Zoja, Diego Casu, Stefano Tambuzzi, Jorge Lopez-Castroman, Giulia Peviani, Michele Fornaro, William Mansi, Fabio Madeddu, Chiara Filipponi, Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), University of Milan, 'Federico II' University of Naples Medical School, Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Calati, R, Filipponi, C, Mansi, W, Casu, D, Peviani, G, Gentile, G, Tambuzzi, S, Zoja, R, Fornaro, M, Lopez-Castroman, J, and Madeddu, F
- Subjects
Male ,medicine.medical_specialty ,Databases, Factual ,[SDV]Life Sciences [q-bio] ,Population ,03 medical and health sciences ,Umbrella review ,0302 clinical medicine ,Suicidal behaviors ,Neoplasms ,Credibility ,medicine ,Humans ,Meta-analysi ,030212 general & internal medicine ,education ,Aged ,Cancer ,education.field_of_study ,business.industry ,Public health ,Publication bias ,medicine.disease ,3. Good health ,Psychiatry and Mental health ,Clinical Psychology ,Meta-analysis ,Suicide ,Systematic review ,Standardized mortality ratio ,Oncology ,030220 oncology & carcinogenesis ,Family medicine ,Suicidal behavior ,business ,Publication Bias ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - 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.
- Published
- 2021
- Full Text
- View/download PDF