Global prevalence and risk factors of suicidality among head and neck cancer patients-systematic review and meta-analysis

Abstract

Purpose: Suicidality is a pertinent issue among head and neck cancer patients. Our primary aim is to investigate the current suicidality rate among head and neck cancer (HNC) patients and evaluate risk factors associated with suicidality.

Methods: We thoroughly searched primary original research from January 2024 onwards across several databases, including PubMed, Embase, ScienceDirect, Web of Science, Scopus, and PsycINFO. Using a random-effects model, we calculated the odds ratio (OR) for risk factors and conducted a proportional meta-analysis to estimate prevalence and 95% confidence intervals (CI).

Results: Out of 15 included studies, 305,146 head and neck cancer patients were included. The global prevalence of suicidality among head and neck cancer patients was estimated at 6.8% (95% CI 2.0-20.6%). Major depressive disorder (RR = 5.13, 95% CI 3.60-7.30), psychiatric disorders (RR = 3.73, 95% CI 2.65-5.25), alcohol abuse (RR = 2.67, 95% CI 1.71-4.16), substance abuse (RR = 2.47, 95% CI 1.58-3.85), smoking/nicotine dependence (RR = 2.03, 95% CI 1.60-2.58), and functional compromise (RR = 1.74, 95% CI 1.29-2.36) were identified as significant risk factors. Subgroup analysis by geographical location revealed variations in prevalence, with Asia reporting lower rates than Europe and North America.

Conclusion: This systematic review reports the current suicidality rate associated with head and neck cancer patients. Major depressive disorder and other psychiatric comorbidities pose substantial risks requiring early intervention in mitigating the burden of suicidality.

Keywords: Cancer survivorship; Prevalence rate; Risk factors; Self-harm; Suicidal ideation.