Lazar Diana Elena, Hanganu Bianca, Postolica Roxana, Buhas Camelia Liana, Paparau Cristian, Ioan Beatrice Gabriela
Doctoral School, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.
Department of Oncology, Municipal Hospital "St. Hierarch Dr. Luca", 601048 Onesti, Romania.
Cancers (Basel). 2025 Apr 24;17(9):1427. doi: 10.3390/cancers17091427.
A cancer diagnosis often triggers profound psychological and emotional distress as individuals reflect on existential issues such as life and death. The aim of this review was to provide estimates of suicide risk associated with digestive cancer worldwide, and to identify sociodemographic, psychological, and clinical factors associated with suicide risk in patients with digestive cancer.
The literature search was guided by the following question: What is the relationship between suicide and digestive cancer, and what sociodemographic, psychological, and clinical factors contribute to the risk of suicide in these patients? We searched PubMed, PsycINFO, Embase, CINAHL, and Web of Science, and systematically reviewed the evidence, according to PRISMA guidelines, from relevant articles on the association between digestive system cancers and suicide outcomes published over a 14-year period (2011-2024). Eligible studies were searched in the main scientific databases up to August 2024.
There are many reasons why people die by suicide, including challenges faced by patients in mentally adapting to their new condition and physical illness. Studies have shown that the highest suicide rates in digestive cancer patients are observed in males, older age groups, single people, those with a poor cancer prognosis, and those with a lack of treatment provision (surgery or chemotherapy). The risk of suicide peaks at six months post-discrimination, remains stable for three years, and then declines.
Systematic changes in cancer care, such as aggressive treatment of pain and physical symptoms, management of delirium and cognitive impairment, routine screening, increased monitoring, and proactive measures for high-risk patients, can play a critical role in preventing unnecessary deaths and addressing the increased vulnerability of cancer patients, underscoring the need for targeted psychological support and early intervention, especially during critical periods like diagnosis and post-treatment recovery.
癌症诊断常常引发深刻的心理和情绪困扰，因为个体开始思考诸如生死等生存问题。本综述的目的是提供全球范围内与消化系统癌症相关的自杀风险估计，并确定消化系统癌症患者中与自杀风险相关的社会人口学、心理和临床因素。
文献检索以以下问题为导向：自杀与消化系统癌症之间的关系是什么，以及哪些社会人口学、心理和临床因素导致这些患者的自杀风险？我们检索了PubMed、PsycINFO、Embase、CINAHL和Web of Science，并根据PRISMA指南，系统回顾了14年期间（2011 - 2024年）发表的关于消化系统癌症与自杀结局之间关联的相关文章的证据。截至2024年8月，在主要科学数据库中检索符合条件的研究。
人们自杀有很多原因，包括患者在心理上适应新状况和身体疾病所面临的挑战。研究表明，消化系统癌症患者中自杀率最高的是男性、老年群体、单身者、癌症预后较差者以及缺乏治疗（手术或化疗）者。自杀风险在确诊后六个月达到峰值，三年内保持稳定，然后下降。
癌症护理中的系统性改变，如积极治疗疼痛和身体症状、处理谵妄和认知障碍、常规筛查、加强监测以及针对高危患者的积极措施，在预防不必要的死亡和解决癌症患者增加的脆弱性方面可以发挥关键作用，强调了针对性心理支持和早期干预的必要性，特别是在诊断和治疗后恢复等关键时期。
