Global incidence, standardized mortality ratio, and risk factors for suicide in head and neck cancer versus other cancer population: a systematic review and meta-analysis.

Suicide incidence and risk factors in head and neck cancer (HNC) vary across studies. To evaluate suicide incidence, standardized mortality ratio (SMR), and predictors in HNC versus other cancers. PubMed, Embase, ScienceDirect, and Web of Science were systematically reviewed until February 2025. A random-effects meta-analysis assessed the outcomes. Out of 1,186 screened articles, 21 studies with 33,768,815 cancer patients (HNC: 2,470,243; non-HNC: 31,298,572) were included (mean age: 66.1 ± 8.82 years). The pooled suicide incidence in HNC was 277.1 per 100,000 (95% CI: 217.5-336.6), the highest among cancer populations, with Asia reporting the highest rate (457.9 per 100,000). The standardized mortality ratio (SMR) for suicide in HNC was 2.62 (95% CI: 2.10-3.26, p < 0.0001), ranking fourth among tumors. Risk factors included age ≥65 years (HR = 1.07, p = 0.03), male gender (HR = 5.55, p < 0.0001), distant metastases (HR = 1.47, 95% CI: 1.14-1.90, p = 0.003), and regional spread (HR = 1.28, p = 0.03). HNC had the highest suicide incidence and ranked fourth in SMR among cancers. Our meta-analysis identified key positive and negative suicide predictors. This meta-analysis provides the current incidence and SMR statistics in HNC compared to the non-HNC population.