CN34 - Suicide and digestive cancer: A systematic review

Background

Suicide as a consequence to a cancer diagnosis and treatment perspectives reflects the multitudinous physical, spiritual and psychological distress and sense of hopelessness that the diagnosis can bring.

The aim of this review was to examine the relationship between suicidal behaviour and the associated risk factors that lead patients with digestive cancer to commit it.

Methods

We searched PubMed, PsycINFO, Embase, CINAHL and Web of Science and systematically reviewed the evidence according to PRISMA guidelines for relevant articles on the association between digestive system cancers and suicide outcomes over the last 13 years (2010–2022). Eligible studies were searched in the main scientific databases through January 2, 2023.

Results

The suicide rate among people with digestive cancer was significantly higher in the United States than in Europe. Overall, the studies examined showed that clinical factors (advanced stage of cancer, severe pain, no surgical treatment or chemotherapy, poor prognosis) and demographic factors (older age, male gender, white race, lack of social support) peaked within six months to 2 years after diagnosis in people who committed suicide. The time between surgery and suicide may be influenced by the type of cancer. Patients with pancreatic cancer usually commit suicide within 2-3 months after surgery.

Conclusions

There are many reasons why people commit suicide, right down to the challenges these patients face in mentally adapting to their new condition and physical illness. It is often the result of a complex interplay of risk and protective factors at individual, interpersonal, community and societal levels. To prevent suicide, we need to maximise protective factors such as: increasing mental acceptance to the cancer diagnosis, ensure early palliative care, regularly screen cancer patients for distress and suicide risk, especially at times of increased suicide risk.

Clinical trial identification

Editorial acknowledgement

Funding: This research received no external funding.

Institutional Review Board Statement: Not applicable.

Informed Consent Statement: Not applicable.

Data Availability Statement: Not applicable.

Conflicts of Interest: I declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.