Suicidal Behavior and Mortality Risk in Thyroid Cancer: A Systematic Review and Meta-Analysis
Author(s)
Ganesh Bhushi, MPharm, Muhammed Shabil, MPharm, Eswaran Maheswari, PhD.
Pharmacy Practice, MS Ramaiah University of Applied Sciences, Bangalore, India.
Pharmacy Practice, MS Ramaiah University of Applied Sciences, Bangalore, India.
OBJECTIVES: Thyroid cancer incidence has risen globally, yet its psychosocial sequelae, including suicidal behavior, remain underinvestigated. This systematic review and meta-analysis aimed to assess the prevalence and risk of suicidal behavior among patients with thyroid cancer, including standardized mortality ratios (SMRs) and associated predictive factors.
METHODS: A systematic search of PubMed, Embase, and Web of Science was conducted through December 2024 to identify observational studies reporting on suicidal behavior in patients diagnosed with thyroid cancer. Data extraction was performed using Nested Knowledge software. Study quality was evaluated using a modified Newcastle-Ottawa Scale. A random-effects model was applied to estimate pooled prevalence and SMRs with 95% confidence intervals (CIs). Heterogeneity was quantified using the I² statistic. Sensitivity analyses and assessments for publication bias were conducted using Doi plots and the Luis Furuya-Kanamori (LFK) index. Statistical analyses were performed in R software.
RESULTS: Of 166 articles screened, 5 studies met inclusion criteria, comprising a total of 724,995 thyroid cancer patients. The pooled prevalence of suicidal behavior was 0.1% (95% CI, 0.05%-0.18%), with substantial heterogeneity (I² = 96%). The pooled SMR for self-inflicted injuries was −0.23 (95% CI, −0.51 to 0.06), suggesting a lower risk of suicide in this population compared with the general population. Male sex was associated with an increased risk of suicide (hazard ratio, 1.93; 95% CI, 1.46-2.55).
CONCLUSIONS: This meta-analysis suggests that suicidal behavior among thyroid cancer patients is rare and not elevated relative to the general population. Although certain subgroups, such as male patients, may be at increased risk, the overall findings indicate a limited need for broad integration of psychosocial services into thyroid cancer care. Future research using longitudinal and culturally diverse cohorts is warranted to confirm these findings and identify potential at-risk subpopulations.
METHODS: A systematic search of PubMed, Embase, and Web of Science was conducted through December 2024 to identify observational studies reporting on suicidal behavior in patients diagnosed with thyroid cancer. Data extraction was performed using Nested Knowledge software. Study quality was evaluated using a modified Newcastle-Ottawa Scale. A random-effects model was applied to estimate pooled prevalence and SMRs with 95% confidence intervals (CIs). Heterogeneity was quantified using the I² statistic. Sensitivity analyses and assessments for publication bias were conducted using Doi plots and the Luis Furuya-Kanamori (LFK) index. Statistical analyses were performed in R software.
RESULTS: Of 166 articles screened, 5 studies met inclusion criteria, comprising a total of 724,995 thyroid cancer patients. The pooled prevalence of suicidal behavior was 0.1% (95% CI, 0.05%-0.18%), with substantial heterogeneity (I² = 96%). The pooled SMR for self-inflicted injuries was −0.23 (95% CI, −0.51 to 0.06), suggesting a lower risk of suicide in this population compared with the general population. Male sex was associated with an increased risk of suicide (hazard ratio, 1.93; 95% CI, 1.46-2.55).
CONCLUSIONS: This meta-analysis suggests that suicidal behavior among thyroid cancer patients is rare and not elevated relative to the general population. Although certain subgroups, such as male patients, may be at increased risk, the overall findings indicate a limited need for broad integration of psychosocial services into thyroid cancer care. Future research using longitudinal and culturally diverse cohorts is warranted to confirm these findings and identify potential at-risk subpopulations.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH221
Topic
Epidemiology & Public Health, Methodological & Statistical Research, Patient-Centered Research
Topic Subcategory
Public Health
Disease
Mental Health (including addition), No Additional Disease & Conditions/Specialized Treatment Areas, Oncology