Background:
People with head and neck cancer (HNC) are three times more likely to die by suicide than the general population. There is an urgency to understand and address the growing rates of suicidality within this population.
Methods:
A mixed-methods systematic review following the PRISMA protocol. Four electronic databases and grey literature searches were completed. A total of 3665 recorded were identified; with 36 studies included. Of these, 22 focused on suicide completion, with sufficient data to conduct a meta-analysis on several suicide completion risk factors. The remaining 14 studies reported on suicide ideation, with a narrative synthesis conducted.
Results:
Risk of suicide ideation and suicide completion was greatest in male patients. Suicide completion was highest in patients within the first six-months of diagnosis, who were widowed, or had cancer of the hypopharynx. Suboptimal pain and symptom management appeared related to a higher risk of suicide ideation. A therapeutic and supportive relationship with professionals was helpful in managing experiences of suicidal ideation.
Conclusion:
Professionals should assess, support and follow-up regarding thoughts of suicide for patients with HNC. Clear pathways are necessary for the management of suicidality, to include appropriate referrals to psychiatry/psychology, supportive interventions to include medications that can help with pain, distress or other symptoms.