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头颈癌患者自杀倾向的全球患病率及危险因素——系统评价与荟萃分析

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

作者信息

Sharma Shivani, Vasudevan Srivatsa Surya, Walker Nakoma, Shimkus Gaelen, Goyal Shriya, Pang John, Beedupalli Kavitha, Nathan Cherie-Ann O

机构信息

Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA.

Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA, 71103, USA.

出版信息

Support Care Cancer. 2025 Mar 15;33(4):286. doi: 10.1007/s00520-025-09244-9.

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.

摘要

目的

自杀倾向是头颈癌患者中一个相关问题。我们的主要目的是调查头颈癌(HNC)患者当前的自杀倾向率,并评估与自杀倾向相关的风险因素。

方法

我们全面检索了2024年1月起多个数据库中的原发性原创研究,包括PubMed、Embase、ScienceDirect、Web of Science、Scopus和PsycINFO。我们使用随机效应模型计算风险因素的比值比(OR),并进行比例荟萃分析以估计患病率和95%置信区间(CI)。

结果

在纳入的15项研究中,共纳入了305,146名头颈癌患者。头颈癌患者中自杀倾向的全球患病率估计为6.8%(95%CI 2.0 - 20.6%)。重度抑郁症(RR = 5.13,95%CI 3.60 - 7.30)、精神疾病(RR = 3.73,95%CI 2.65 - 5.25)、酒精滥用(RR = 2.67,95%CI 1.71 - 4.16)、药物滥用(RR = 2.47,95%CI 1.58 - 3.85)、吸烟/尼古丁依赖(RR = 2.03,95%CI 1.60 - 2.58)和功能受损(RR = 1.74,95%CI 1.29 - 2.36)被确定为显著风险因素。按地理位置进行的亚组分析显示患病率存在差异,亚洲报告的患病率低于欧洲和北美。

结论

本系统评价报告了与头颈癌患者相关的当前自杀倾向率。重度抑郁症和其他精神疾病合并症构成重大风险,需要早期干预以减轻自杀倾向的负担。

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