Suicide in Digestive System Cancers: A Scoping Review

Digestive system cancers are important causes of morbidity and mortality worldwide. Cancer patients are more likely to commit suicide. The objective of this scoping review is to provide a comprehensive and updated sum-mary of the existing literature on suicide among patients with digestive system cancers to identify the incidence and risk factors relevant to suicide in these populations. The PRISMA-Scr (Preferred Reporting Items for Sys-tematic reviews and Meta-Analyses extension protocol for scoping reviews) protocol was used. The review was based on relevant articles published prior to January 2022 in databases of Web of Science and PubMed. The authors identified 21 records that met the criteria for inclusion. Among the 21 articles, 18 (n = 85.7%) reported suicide risk factors, 21 (n = 100%) evaluated the incidence of suicide and 16 (n = 76.2%) involved the variation in suicide rates. Only one study comprehensively reported that the suicide rate for this population was 32.8 per 100,000 years and the standardized mortality ratio (SMR) was 1.91. Most suicides occurred in patients with pan-creatic, esophageal, and gastric cancers. The factors associated with suicide in digestive system cancers included male gender, older age, the white race, single status, advanced stage of disease, and cancer metastasis. The most critical time for suicide was in the early post-diagnostic period. It is indispensable to identify suicide in these can-cer patients, especially those with high-risk factors. In the future, more prospective research may be needed to provide more reliable support and care to prevent suicide.