癌症患者的自杀与死亡率

SCI

9 MAy 2022

Suicide risk and mortality among patients with Cancer

（IF: Nat. Med., 53.44）

• Heinrich M, Hofmann L, Baurecht H, Kreuzer PM, Knüttel H, Leitzmann MF, Seliger C. Suicide risk and mortality among patients with cancer. Nat Med. 2022 Apr;28(4):852-859. 

• Correspondence and requests for materials should be addressed to Corinna Seliger. (by mail at Corinna.Seliger-Behme@med.uni-heidelberg.de)

Despite substantial progress in cancer therapy in recent decades, patients with cancer remain at high suicide risk. Data from individual studies have not been comprehensively quantified and specific risk factors are ill-defined. We assessed suicide mortality risk according to cancer prognosis, stage, time since diagnosis, gender, ethnicity, marital status, year of recruitment and geographic region. We searched EMBASE, MEDLINE, PsycINFO, Web of Science, CINAHL and Google Scholar for relevant articles up to February 2021. We used a random effects model, performed meta-regression meta-analysis and assessed heterogeneity and publication bias using I2, funnel plots and Egger’s and Begg’s tests. We performed a systematic review including 62 studies and 46,952,813 patients. To avoid patient sample overlap, the meta-analysis was performed on 28 studies, involving 22,407,690 patients with cancer. Suicide mortality was significantly increased compared with the general population (standardized mortality ratio = 1.85, 95% confidence interval = 1.55–2.20). Risk was strongly related to cancer prognosis, cancer stage, time since diagnosis and geographic region. Patients with cancer, particularly those with specific risk factors, should be closely monitored for suicidality and need specialized care to reduce short- and long-term risks of suicide.

尽管近几十年来癌症治疗取得了一些实质性进展，但癌症患者仍有很高的自杀风险。个别研究的数据尚未得到全面量化，具体风险因素定义不明确。我们根据癌症预后、分期、确诊时间、性别、种族、婚姻状况、招募年份和地理区域评估了自杀死亡风险。截至2021年2月，我们在EMBASE、MEDLINE、PsycINFO、Web of Science、CINAHL和Google Scholar网站上搜索了相关文章。我们使用随机效应模型，进行荟萃回归荟萃分析，并使用I2、漏斗图、Egger和Begg测试评估异质性和发表偏倚。我们进行了系统性回顾，包括62项研究和46,952,813名患者。为了避免患者样本重叠，对28项研究进行了荟萃分析，涉及22,407,690名癌症患者。与普通人群相比，自杀死亡率显著增加（标准化死亡率=1.85，95%置信区间=1.55–2.20）。风险与癌症预后、癌症分期、确诊时间和地理区域密切相关。癌症患者，尤其是那些有特定危险因素的患者，应密切监测其自杀行为，并需要专门护理以降低短期和长期自杀风险。