Risk Factors for Suicide Among Head and Neck Cancer Patients: A Systematic Review and Meta-Analysis

Abstract

Background: Head and neck cancer (HNC) patients have an elevated suicide risk. This study examines suicide risk factors among HNC patients. Methods: Databases were reviewed through June 2024 for articles examining HNC patient suicide. HNC patients, non-HNC cancer patients, and suicide case numbers were stratified by patient variables. Meta-analyses of proportions and relative risk (RR) were performed. Results: Twenty-one studies with 1 610 031 HNC and 16 857 218 non-HNC cancer patients were included. HNC patients had a higher suicide risk than non-HNC cancer (RR 2.369) and general population (RR 26.991) cohorts. Non-Hispanic ethnicity (RR 3.773), male sex (RR 2.721), and oropharyngeal (RR 1.241) or laryngeal (RR 1.182) cancers increased risk. Being Black (RR 0.316), Hispanic (RR 0.265), and female (RR 0.367) decreased risk. Excluding studies only examining laryngeal cancer intensified sex and race effects on suicide risk. Conclusions: HNC patients have a higher suicide risk than other cancer patients. Laryngeal cancer attenuates the effects of other variables.