Recently findings that marital status is associated with survival in patients with late-stage prostate cancer led to an examination of the generalizability of this association for all cancers. We restricted the investigation to patients with late-stage cancer using population-based data collected from 261,070 patients with late-stage cancer at multiple sites in the United States to determine relations between marital status and survival. After controlling for age, race, and treatment, married patients with cancers of all major primary sites had significantly better survival than single, separated, divorced, or widowed patients. Although single and widowed patients had the poorest prognosis in general, single patients appeared to show the most consistently poor survival across the different types of cancers. Survival differences by marital status were more pronounced in men than in women. This observation raises the possibility that some characteristics associated with being married delay death from cancer. These findings require investigators to ask new questions about the effect of being married and its possible correlates, such as general health status, access to health care, and socioeconomic status. Known correlates of marital status, such as available social support and social isolation also merit attention in relation to these findings.
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Berkman, L. F., & Syme, S. L. (1979). Social networks, host resistance and mortality: A nine year follow-up study of Alameda County residents. American Journal of Epidemiology, 109, 186–204.
Coombs, R. H. (1991). Marital status and personal well-being: a literature review. Family Relations, 40, 97–102.
Cox, D. R. (1972). Regression models and life tables. Journal of the Royal Statistical Society, 34, 187.
Ell, K., Nishirnoto, R., Medeansky, L., Mantell, J., & Hamovitch, M. (1992). Social relations, social support and survival among patients with cancer. Journal of Psychosomatic Research, 36, 531–541.
Fidler, I. J. (1990). Critical factors in the biology of human cancer metastasis: Twenty-eighth GHA Clowes memorial award lecture. Cancer Research, 50, 6130.
Fidler, I. J., Gersten, D. M., & Hart, I. R. (1978). The biology of cancer invasion and metastasis. Advances in Cancer Research, 28, 149.
Ganz, P. A., Lee, J. J., & Siau, J. (1990). Quality of life assessment: An independent prognostic variable for survival in lung cancer. Cancer, 67, 3131–3135.
Goodwin, J. S., Hunt, W. C., Key, C. R., & Samet, J. M. (1987). The effect of marital status on stage, treatment, and survival of cancer patients. Journal of the American Medical Association, 258, 3125–3130.
Gove, W. R. (1972). The relationship between sex roles, marital status, and mental illness. Social Forces, 51, 34–44.
Hastie, T. J., & Tibshirani, R. T. (1986). Generalized additive models. Stat Sci, 1, 97–318.
Kaplan, E. L., & Meier, P. (1958). Nonparametric estimation from incomplete observations. Journal of the American Statistical Association, 53, 457.
Kaprio, J., Koskenvuo, M., & Rita, H. (1987). Mortality after bereavement: A prospective study of 96,647 widowed persons. American Journal of Public Health, 77, 283–287.
Kato, I., Tominaga, S., & Ikari, A. (1992). The role of socioeconomic factors in survival of patients with gastrointestinal cancers. Japanese Journal of Clinical Oncology, 22, 270–277.
Krongrad, A., Lai, H., Burke, M. A., Goodkin, K., & Lai, S. (1996). Marriage and mortality in prostate cancer. Journal of Urolology, 156, 1696–1700.
Kvikstad, A., Vatten, L. J., & Tretli, S. (1995). Widowed and divorce in relation to overall survival among middle-age Norwegian women with cancer. British Journal of Cancer, 71, 1343–1347.
Last, J. M., Abramson, J. H., Friedman, G. D., Porta, M., Spasoff, R. A., & Thuriaux, M. (1995). A dictionary of epidemiology (3rd ed.). New York: Oxford University Press.
Murphy, M. F. G., Goldblatt, P. O., & Mant, D. (1993). Marital stability and cancer of the uterine cervix: Changing patterns in post-war Britain. International Journal of Epidemiology, 22, 385–392.
Nayeri, K., Pitaro, G., & Feldman, J. G. (1992). Marital status and stage at diagnosis in cancer. New York State Journal of Medicine, 92, 8–11.
Ortmeyer, C. F. (1974). Variables in mortality, morbidity, and health care by marital status. In L. L. Erhardt & J. E. Berlin (Eds.), Mortality and morbidity in the United States (pp. 159–184). Cambridge, MA: Harvard University Press.
Parker, S. L., Tong, T., Bolden, S., & Wingo, P. A.(1997). Cancer statistics, 1997. Ca: A Cancer Journal for Clinicians, 47, 5–27.
Reynolds, P., Boyd, P. T., Blacklow, R. S., Jackson, J. S., Greenberg, R. S., & Austin, D. F. (1994). The relationship between social ties and survival among black and white breast cancer patients. Cancer Epidemiology, Biomarkers, and Prevention, 3, 253–259.
Ries, L. A. G., Miller, B. A., Hankey, B. F, Koary, C. L., Harras, A., & Edwards, B. K.(Eds.). (1994). SEER cancer statistics review: 1973–1991. Tables and graphs. (National Institiute of Health Publication No. 94-2789). Bethesda, MD.
Rothman, K. J., & Greenland, S. (1998). Modern epidemiology (2nd ed.). Philadelphia: Lippincott.
Schaefer, C., Quesenberry, C. P., & Wi, S. (1995). Mortality following conjugal bereavement and the effects of shared environment. American Journal of Epidemiology, 141, 1142–1152.
Spiegel, D., Kraemer, H. C., Bloom, J. R., & Gottheil, E. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 2, 888–891.
Sugarbaker, E. V. (1979). Cancer metastasis: A product of tumor-host interactions. Current Problems in Cancer, 3, 1.
Weiss, L. Principles of metastasis. (1985). Orlando, FL: Academic.
Willis, R. A. The spread of tumors in the human body. (1972). London: Butterworth.
Young, J. L., Percy, C. L., & Asire, A. J. (Eds.). (1981). Surveillance, epidemiology and end results: Incidence and mortality data, 1973-1977 (NIH Monograph 57). Bethesda, MD: National Cancer Institute.
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Lai, H., Lai, S., Krongrad, A. et al. The effect of marital status on survival in late-stage cancer patients: An analysis based on surveillance, epidemiology, and end results (SEER) data, in the United States. Int. J. Behav. Med. 6, 150–176 (1999). https://doi.org/10.1207/s15327558ijbm0602_4
- marital status
- late stage