Cancer survival may be related to marital status

A fascinating study was recently published in the journal Cancer (Here is the abstract. It appears you need a subscription to get the full article, however). The study was also written up in the lay press.

In a nutshell, the authors used the NCI SEER database (what would we do without SEER?) from 1973 to 2004 to find patients "actively followed" for malignancy for SEER's relative survival rates, with marital status as their explanatory variable. The relative survival variable is age, gender and race matched. The authors hypothesized that the patient's type of single status (never married, divorced, widowed or separated) would determine cancer survival. In the end, married patients did have the best survival (63% alive at five years), and separated patients had the worst (45% alive at five years).

The survival hierarchy by marital status was interesting as well: (1) married, (2) never married, (3) divorced, (4) widowed and (5) separated. Although intriguing, it is most disappointing that the authors did not include a demographics table — type of cancer, income, stage of cancer — as all can be predictors of survival as well. Regardless, this paper strengthens the immune-stress-cancer link for me, as a clinician. The authors conclude that their findings may be driven by the benefits of being married — better income, built-in social support and improved health-related behaviors. I assume these translate into lower stress, resulting in better immunity and better cancer outcomes. These associations may also translate into married folks getting more aggressive care or high rates of cancer screening (what I believe is another likely explanation for the findings).

(And, for your reading pleasure, allow me to present the most ridiculous title of a news article discussing this paper: "Marriage, the secret to beating cancer!" Good grief.)