Assessment and Reporting of Self-Harm and Suicidal Ideation Among Adolescents and Young Adults with Cancer: A Mixed-Methods Systematic Review
Seminars in Oncology Nursing, vol.42, no.4, 2026 (SCI-Expanded, SSCI, Scopus)
- Publication Type: Article / Article
- Volume: 42 Issue: 4
- Publication Date: 2026
- Doi Number: 10.1016/j.soncn.2026.152290
- Journal Name: Seminars in Oncology Nursing
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, EMBASE, MEDLINE
- Keywords: Adolescent, Cancer, Self-harm, Suicidal ideation, Systematic review, Young adult
- Hacettepe University Affiliated: Yes
Abstract
Objectives: Adolescents and young adults (AYAs) with cancer may face unique developmental and psychosocial challenges that heighten vulnerability to depression, self-harm, and suicide. This study aims to synthesize how self-harm and suicidal ideation are identified, measured, and documented among AYAs with cancer. Methods: A mixed-methods systematic review was conducted following PRISMA guidelines and registered with PROSPERO (CRD42024464198). Eight databases were searched to January 2026. Eligible quantitative, qualitative, and mixed-methods studies were screened, appraised using MMAT, and synthesized using a convergent integrated approach. Results: Five studies met the inclusion criteria: 3 cohort studies, 1 quantitative descriptive study, and 1 mixed-methods study. Considerable variation existed in outcome definitions, measurement tools, and assessment timing. Three themes emerged: (1) elevated risk of suicidal ideation and behavior after cancer diagnosis especially in the first year and among subgroups such as men with testicular cancer; (2) persistent psychological vulnerability in survivorship, including long-term depression, anxiety, loneliness, and substance use; (3) social isolation and unmet needs as drivers of distress, with loneliness and lack of age-appropriate support strongly linked to suicidal ideation. All studies were rated as low methodological quality, limiting comparability and precluding meta-analysis. Conclusions: AYAs with cancer may be at increased risk of suicidality and enduring psychological distress. Consistent assessment practices and targeted psychosocial interventions are needed to reduce risk and improve well-being. Implications for Nursing Practice: Routine, developmentally informed screening for suicidality is needed from diagnosis through survivorship. Interventions should prioritize social connectedness and tailored psychosocial support for AYAs.