Assessment and Reporting of Self‑Harm and Suicidal Ideation Among Adolescents and Young Adults with Cancer: A...

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.

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.

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.

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.

Routine, developmentally informed screening for suicidality is needed from diagnosis through survivorship. Interventions should prioritize social connectedness and tailored psychosocial support for AYAs.