@article{ref1,
title="Incidence and risk factors of suicide among patients diagnosed with bladder cancer:  a systematic review and meta-analysis",
journal="Urologic oncology",
year="2020",
author="Guo, Zhenlang and Gu, Chiming and Li, Siyi and Gan, Shu and Li, Yuan and Xiang, Songtao and Gong, Leiliang and Wang, Shusheng",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Patients with bladder cancer have a high risk of suicide. This study  aimed to assess how bladder cancer increases suicide risk and to identify the  demographic and clinical factors associated with suicidal death among patients with  bladder cancer. <br><br>METHODS: Literature search of MEDLINE, PsycINFO, Embase, Web of  Sciences and Cochrane Library databases was conducted up to April 2020 to identify  eligible studies related to the incidence and risk factors of suicide after bladder  cancer diagnosis. Summary multivariate-adjusted risk estimates and their associated  95% confidence intervals (CIs) were calculated using inverse variance method with  random or fixed-effect modeling. <br><br>RESULTS: Five retrospective cohorts comprising  563,680 patients with bladder cancer were included. Higher risk of suicide by  1.90-fold was observed among patients with bladder cancer (hazard ratio, HR = 1.90,  95% CI: 1.29-2.81; P = 0.001; I(2) = 81.2%), especially in those aged 70 years or  older (HR = 1.36, 95% CI: 1.29-1.43; P < 0.001; I(2) = 0%), unmarried (HR = 1.72,  95% CI: 1.61-1.83; P < 0.001; I(2) = 0%), and those with regional bladder cancer  (HR = 1.88, 95% CI: 1.10-3.21; P = 0.021; I(2) = 96.3%), compared with those without  bladder cancer. Furthermore, gender and race were not associated with increased  suicide risk among patients with bladder cancer. <br><br>CONCLUSIONS: Suicide risk is  increased among patients with bladder cancer, particularly those aged 70 years or  older, unmarried and those with regional bladder cancer. Hence, early psychological  support must be provided during the follow-up period of these special populations  with a high suicide risk.<p /> <p>Language: en</p>",
language="en",
issn="1078-1439",
doi="10.1016/j.urolonc.2020.11.022",
url="http://dx.doi.org/10.1016/j.urolonc.2020.11.022"
}