School of Medicine, Nantong University, Nantong, China.
School of Public Health, Nantong University, 9# Seyuan Road, Nantong, 226000, Jiangsu, China.
Support Care Cancer. 2022 Apr;30(4):2945-2957. doi: 10.1007/s00520-021-06604-z. Epub 2021 Oct 10.
To explore the high-risk period of the occupation of suicide after diagnosis; and clarify the risk factors of suicidal behaviors (suicidal ideation, suicide attempt, and suicidal death) behind the lung cancer patients during the cancer cure process.
This scoping review was conducted through the whole month of April 2021. We extracted data of the suicide mortality after diagnosis and latent risk factors of suicidal behaviors among lung cancer patients where we used to study from the two online databases which are PubMed and Web of Science. Two online databases were searched and written in English without age restriction. To note that the standardized mortality ratio (SMR), person-years, and odds ratio (OR) associated with lung cancer were documented.
Out of 570 records, 23 studies mentioned suicidal behaviors and lung cancer met the included criteria. Eleven (n = 47.8%) of the selected publications reported changes in suicide mortality. None of them reported suicidal ideation or suicide attempt after diagnosis. The individuals with lung cancer have significantly higher rates of suicidal death (SMR, 2.04-13.4) during the first years after diagnosis and decrease over subsequent years (SMR, 0.66-3.17). The median time from cancer diagnosis to suicide death was around 7 months. Across all studies with the 22 studies that examined factors, we extracted the data of the suicidal ideation (n = 3), suicide attempt (n = 1), and suicidal death (n = 18) in individuals. For patients with suicidal ideation, there was a significantly higher incidence in males than in females. Among patients who attempted suicide, the incidence of mental illness is greater than the incidence of physical illness. Factors for suicidal death, including gender (male, 56.3-100%), prognosis tumors (poor, 25.8-66.3%), marital status (widowhood or unmarried, 19-75.7%), and age of patients (> 70 years, 24.5-47%) with lung cancer, play a vital role. Treatment of lung cancer is expected to affect a patient in his/her mental state.
Overall, our finding indicates that lung cancer patients have been presented with a higher incidence of suicide death in a specific period, especially the early years after diagnosis. Discovering risk factors for suicide helps prevent potential suicide. It is essential to screen lung cancer patients for suicidal ideation, especially those with high-risk factors. Future prospective studies are necessary to confirm these findings to support care.
探讨肺癌患者确诊后自杀的高危时期；阐明癌症治疗过程中肺癌患者自杀行为（自杀意念、自杀未遂和自杀死亡）背后的风险因素。
本范围综述于 2021 年 4 月整月进行。我们从两个在线数据库 PubMed 和 Web of Science 中提取了肺癌患者自杀死亡率和自杀行为潜在风险因素的数据，这些数据用于研究。两个在线数据库均进行了检索且未设年龄限制。请注意，记录了与肺癌相关的标准化死亡率比（SMR）、人年和比值比（OR）。
在 570 条记录中，有 23 项研究提到了自杀行为和肺癌，符合纳入标准。选定的出版物中有 11 项（n=47.8%）报告了自杀死亡率的变化。它们均未报告确诊后自杀意念或自杀未遂。确诊后最初几年，肺癌患者自杀死亡的比率显著升高（SMR，2.04-13.4），随后几年逐渐下降（SMR，0.66-3.17）。从癌症诊断到自杀死亡的中位时间约为 7 个月。在所有研究中，有 22 项研究检查了因素，我们从中提取了自杀意念（n=3）、自杀未遂（n=1）和自杀死亡（n=18）患者的数据。对于有自杀意念的患者，男性的发生率明显高于女性。在自杀未遂的患者中，精神疾病的发病率高于身体疾病。自杀死亡的因素包括性别（男性，56.3-100%）、肿瘤预后（不良，25.8-66.3%）、婚姻状况（丧偶或未婚，19-75.7%）和年龄（>70 岁，24.5-47%），这些因素对肺癌患者的影响至关重要。肺癌的治疗预计会影响患者的精神状态。
总体而言，我们的研究结果表明，肺癌患者在特定时期，尤其是确诊后最初几年，自杀死亡的发生率较高。发现自杀风险因素有助于预防潜在的自杀行为。对有自杀意念的肺癌患者进行筛查，特别是对具有高危因素的患者进行筛查，这一点至关重要。未来有必要进行前瞻性研究以证实这些发现，为护理提供支持。
