Suicide mortality and suicidal ideation among patients with colorectal cancer: a systematic review and meta-analysis
Notice bibliographique
Résumé
Background Receiving a cancer diagnosis is strongly associated with a higher risk of suicide. However, studies examining suicidality in patients with colorectal cancer show some inconsistencies, particularly concerning factors such as disease stage or specific diagnosis. Methods We conducted a systematic review and meta-analysis to investigate the association between colorectal cancer and suicide or suicidal ideation. EMBASE, MEDLINE, PsycINFO, Science Citation Index Expanded & Social Sciences Citation Index, CINAHL, and Google Scholar were searched from database inception to May 31, 2025. Eligible studies included longitudinal cohort or case–control designs involving patients with colorectal cancer aged ≥14 years. Control groups comprised individuals from the same population without cancer. Data were independently extracted by two researchers from published reports available in English or German. The primary outcome was suicide, defined as death from intentional self-harm; the secondary outcome was suicidal ideation, defined as non-fatal thoughts of suicide. We performed random-effects meta-analyses, assessing heterogeneity with Q and I 2 statistics and publication bias with funnel plots, Begg's, and Egger's tests. The study was registered (PROSPERO: CRD420251051277). Findings Among 4,700 records screened, 44 studies met the inclusion criteria, encompassing at least 9,385,472 patients with colorectal cancer and 13,308 suicides. Of these, 34 studies reported Standardised Mortality Ratios (SMR; colorectal cancer patients: n=8,251,924; suicides: n=12,081) and were included in the meta-analysis. After excluding studies with potential overlap in patient populations, the primary analysis was based on nine independent studies including at least 1,204,072 individuals with colorectal cancer, of whom 2,731 died by suicide. For suicidal ideation, we report the results of five individual studies. All included studies met methodological quality criteria, with a Newcastle–Ottawa Scale score of ≥7. The findings indicate a significantly increased suicide risk for patients with colorectal cancer, with a pooled SMR of 1.40 (95% CI: 1.33–1.49, I 2 = 28.17%, no evidence for publication bias) compared to the general population. Subgroup analyses revealed notably higher suicide risks among patients with metastatic disease (SMR = 3.63, 95% CI: 2.99–4.41), those under 40 years of age (SMR = 2.15, 95% CI: 1.60–2.88), and individuals diagnosed within the past six months (SMR = 2.69, 95% CI: 1.29–5.61). For suicidal ideation, primary studies did not observe differences between patients with colorectal cancer and their reference groups, such as cancer-free individuals (SMR = 1.70, 95% CI: 0.65–4.42) or patients with hepatic cancer (SMR = 1.14, 95% CI: 0.94–1.38). Interpretation Our results indicate the need for comprehensive psychological screening in patients with colorectal cancer, who show a substantially higher suicide risk than the general population. Particular attention should be given to vulnerable subgroups, including those with metastatic disease, younger patients, and those recently diagnosed. Implementing these results into clinical practice can help facilitate patient-centred, cost-effective psycho-oncological care. Notably, evidence from low- and middle-income countries remains scarce, and younger populations might be underrepresented, indicating that our results should be interpreted with caution for these groups. Funding None.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,016 | 0,002 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».