Document Detail

Decreased cancer survival in individuals separated at time of diagnosis: critical period for cancer pathophysiology?
MedLine Citation:
PMID:  19705348     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: : It long has been recognized that married patients have improved cancer survival when compared with unmarried patients. This has been postulated as being due to increased support, potentially leading to better compliance with therapy. Conversely, some data exist pointing to a relationship between marital discord and decreased immunity. We examined whether unmarried patients have a different prognosis by whether they are 1) never married, 2) divorced, 3) widowed, or 4) separated at time of diagnosis.
METHODS: : The public access data of the Surveillance, Epidemiology and End Results (SEER) registry were queried for cancer survival across all 17 registries between 1973 and 2004. SEER last updated data in April 2007. Records of 3.79 million patients were included in the analysis. We specifically analyzed 5-year and 10-year relative survival (RS; 5yRS, 10yRS), defined as observed survival divided by observed survival of an age-matched, race-matched, and gender-matched population without disease, for all cancer patients by marital status, with specific subset analyses as indicated.
RESULTS: : Among unmarried patients, those separated at time of diagnosis had the lowest survival, followed by widowed, divorced, and never married patients. 5-year and 10-year RS of separated patients was 72% and 64% than that of married patients, respectively. This relationship persists when data are analyzed by gender.
CONCLUSIONS: : Separated marital status is associated with a significant decrement in cancer survival, even in comparison with other unmarried groups. While other socioeconomic variables could contribute to this phenomenon, further research into the immunologic correlates of the acutely stressful condition of marital separation should be conducted. Cancer 2009. (c) 2009 American Cancer Society.
Gwen C Sprehn; Joanna E Chambers; Andrew J Saykin; Andre Konski; Peter A S Johnstone
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Cancer     Volume:  115     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-26     Completed Date:  2009-12-11     Revised Date:  2014-09-12    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5108-16     Citation Subset:  AIM; IM    
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MeSH Terms
Marital Status
Neoplasms / mortality*
SEER Program
Single Person
Survival Analysis
Grant Support
CA101318/CA/NCI NIH HHS; R01 CA101318/CA/NCI NIH HHS; R01 CA101318-05/CA/NCI NIH HHS
Comment In:
Cancer. 2010 Dec 1;116(23):5564; author reply 5564   [PMID:  20665485 ]
Cancer. 2010 Nov 1;116(21):5111; author reply 5111-2   [PMID:  20623782 ]

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