This article is more than 5 years old. Information may no longer be current.
Marital status predicted outcome in various cancer types
Click Here to Manage Email Alerts
Patients with cancer who were unmarried were significantly more likely to present with metastatic disease and experience cancer-specific mortality than married patients, according to study results.
Those who were unmarried also were at significantly greater risk for undertreatment.
“Physicians caring for unmarried patients with cancer should be aware of the poorer outcomes seen in this population, and health care systems should consider investing in highly targeted social support services and interventions that may help to reduce the significant survival differences between married and unmarried patients with cancer,” the researchers wrote.
Ayal A. Aizer, MD, chief resident of the Harvard Radiation Oncology Program, and colleagues conducted the study to assess the effect of marital status on cancer stage at diagnosis, the use of definitive therapy and cancer-specific mortality.
They used the SEER database to identify 734,889 patients diagnosed with cancer between 2004 and 2008. Diagnoses included lung, colorectal, breast, pancreatic, prostate, liver/intrahepatic bile duct, head and neck, ovarian and esophageal cancers, as well as non-Hodgkin’s lymphoma.
After adjustments for demographics, cancer stage and treatment, researchers determined married patients were less likely to present with metastatic disease (adjusted OR=0.83; 95% CI, 0.82-0.84) and die from their cancer (adjusted HR=0.80; 95% CI, 0.79-0.81). Married patients also were more likely to receive definitive therapy (adjusted OR=1.53; 95% CI, 1.51-1.56).
The associations remained significant even after each cancer type was assessed (P<.05 for all endpoints).
Paul Nguyen
“We don’t just see our study as an affirmation of marriage, but rather it should send a message to anyone who has a friend or a loved one with cancer. By being there for that person and helping them navigate their appointments and make it through all their treatments, you can make a real difference to that person’s outcome,” researcher Paul L. Nguyen, MD, a radiation oncologist at Dana-Farber Cancer Center and Brigham and Women’s Hospital, said in a press release.
For all outcome measures assessed, the beneficial effect associated with being married was greater in men (P<.001). Also, the survival benefit associated with marriage was higher than the published survival benefit of chemotherapy for patients with prostate, breast, colorectal, esophageal and head/neck cancers.
“Aizer and colleagues have reminded us of the power of human attachment in showing the contribution of marital status to survival,” David W. Kissane, MD, of Monash University in Victoria, Australia, Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical College, wrote in an accompanying editorial. “They stress why medicine ought not to be governed by money but by humanistic, culturally sensitive, and comprehensive care. Our response must be to develop targeted supportive programs to attend to those most in need — a paradigmatic change in the focus of healing care that truly accompanies the biologic and scientific pursuits of medicine.”
For more information:
-
Aizer AA. J Clin Oncol. 2013;doi:10.1200/JCO.2013.49.6489.
-
Kissane DW. J Clin Oncol. 2013;doi:10.1200/JCO.2013.51.5080.
Disclosure: The researchers report research funding from Varian Medical Systems, and consultant or advisory roles with Ferring Pharmaceuticals and Medivation.