Suicidal ideation significantly higher among childhood cancer survivors
Key takeaways:
- Childhood cancer survivors are at increased risk for suicidal ideation.
- Risk is particularly elevated among males and those in poor physical health.
Childhood cancer survivors in Europe exhibited higher risk for suicidal ideation than the general population, according to results of a systematic review and meta-analysis.
This finding highlights “the psychological impact of cancer,” researcher Cyrus Su Hui Ho, MBBS, PhD, MSc, assistant professor and senior consultant psychiatrist in the department of psychological medicine at Yong Loo Lin School of Medicine at National University of Singapore, told Healio.
“However, contrary to expectations, the suicide risk was not significantly higher [among childhood cancer survivors] compared with non-cancer peers, possibly due to the limited number of studies included in our meta-analysis,” Ho said.
The ability to obtain reliable estimates about prevalence of suicidal ideation and suicide rates among childhood cancer survivors can inform prevention strategies that can implemented during or after treatment, according to study background.
Ho and colleagues used PubMed, Embase, Cochrane Library and PsycINFO to conduct a search of literature published between Jan. 1, 2000, and Nov. 17, 2024.
They excluded studies that included patients aged older than 25 years and studies that did not have reported outcomes. They also exclude review articles, case studies and case reviews.
Prevalence of suicide and suicidal ideation, relative risk ratio of suicide and suicide ideation among childhood cancer survivors compared with controls, and risk factors associated with suicidality outcomes served as main outcomes.
The analysis included 16 studies that examined suicide (n = 148,869) or suicidal ideation (n = 20,140).
Results showed prevalence of suicide of 0.3% (95% CI, 0.13%-0.69%) and a prevalence of suicidal ideation of 9% (95% CI, 7%-11%) among childhood cancer survivors.
Childhood cancer survivors exhibited significantly increased risk for suicidal ideation (RR = 1.67; 95% CI, 1.39-2.01) but not for suicide (RR = 1.5; 95% CI, 0.63-3.62) compared with the general European population.
Subgroup analysis revealed a higher prevalence of suicidal ideation among childhood cancer survivors during active cancer treatment than during the rest of the follow-up period (0.14 vs. 0.08).
“Key risk factors included pre-existing mental illness, poor physical health, older age, male sex and being single,” Ho said. “These findings underscore the necessity for targeted mental health support throughout survivorship.”
Researchers acknowledged study limitations. For example, the limited number of studies prevented planned subgroup analysis on risk factors. They also noted heterogeneity within the study pool and the potential for underreported suicidal ideation because of social stigma.
“Future research could further stratify childhood cancer survivors based on factors such as cancer type, treatment modality and socioeconomic background to provide a more nuanced understanding of suicidality risk,” Ho told Healio. “Longitudinal studies are necessary to capture the evolving trajectory of suicide risk across the survivorship continuum, identifying critical vulnerability periods — particularly during major transitions such as the completion of active treatment or reintegration into daily life.
“Additionally, investigating the impact of psychosocial interventions and support systems on mitigating suicidality risk could inform the development of targeted mental health strategies for childhood cancer survivors,” he added.
For more information:
Cyrus Su Hui Ho, MBBS, PhD, MSc, can be reached at pcmhsh@nus.edu.sg.
Collapse