Suicidality risk of cancer caregivers: a systematic review and meta-analysis of observational studies

TL;DR

This study finds that caregivers of cancer patients face a higher risk of suicidal thoughts, especially when caring for those with aggressive cancers.

Contribution

The study is the first to systematically review and meta-analyze suicidality risk among cancer caregivers using observational data.

Findings

Caregivers of cancer patients have a 1.91 times higher odds of suicidality compared to non-caregivers.

Caregivers of patients with aggressive cancers face a 1.66 times higher risk of suicidality.

The elevated risk of suicidality among caregivers persists for up to 7 years after diagnosis.

Abstract

The increase in the number of global cancer cases is expected to lead to a greater caregiving burden. However, few studies have investigated the risk of suicidality among cancer caregivers.

The aim of this systematic review was to explore the risk of suicidality among cancer caregivers.

For this systematic review, a comprehensive search of the PubMed, Embase, Cochrane, Web of Science databases, PsycINFO and Scopus databases was conducted from inception to 16 July 2025. A meta-analysis was performed to determine the odds ratios (ORs) for case-control and cross-sectional studies and the adjusted hazard ratios (aHRs) for cohort studies.

Seven studies were included (four cohort studies, one case-control study and two cross-sectional studies), and 638,188 study subjects and 4,203,957 nonexposed subjects. The meta-analyses revealed that the ORs was 1.91 (95% confidence interval [CI]: 1.46–2.49) in the case-control study, cross-sectional studies, and one cohort study which reported ORs, and the aHRs was 1.32 (95% CI: 1.16–1.50) in the three cohort studies. Caregivers of patients with highly aggressive cancers had a greater risk of suicidality (aHR = 1.66; 95% CI: 1.48–1.86). Within the first 7 years following a patient’s cancer diagnosis, the risk of suicidality among caregivers remained elevated (aHR = 1.42; 95% CI: 1.04–1.94).

The results indicate the need for both clinical and societal awareness to reduce the risk of suicidality among cancer caregivers, especially those with highly aggressive cancers.

Registered prospectively in PROSPERO (https://www.crd.york.ac.uk/prospero/) with the registration number (PROSPERO CRD420251011926) and date of registration(15/03/2025).

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