Being Married Helped Prolong Survival in Cancer Patients

Unmarried patients with some of the most common types of cancer had higher risk for mortality compared with their married counterparts, a new study published in Cancer indicated.

Compared with people who were married, unmarried men had a 27% increased risk for death and unmarried women had a 19% increased risk for death. Some of the difference in risk may be explained by insurance status or living in higher socioeconomic status neighborhoods.

“Because economic resources likely play a minimal role in explaining the detrimental survival experienced among unmarried cancer patients, future research that focus on social support and other socially mediated factors associated with marriage may provide an important avenue to inform interventions that improve cancer survival,” wrote Scarlett Lin Gomez, PhD, Cancer Prevention Institute of California, and colleagues.

In this large study, Gomez and colleagues looked at information from 783,167 patients with the 10 most common types of cancer taken from the California Cancer Registry from 2000 to 2009. Almost all patients included in the study had some type of health insurance. Those patients who were unmarried were more likely to be in the youngest or oldest age categories, to live in lower socioeconomic status neighborhoods, to be uninsured or have public insurance, to be diagnosed at a later stage, and to not receive surgery or radiation.

The data revealed that unmarried men (hazard ratio [HR], 1.27 [95% CI, 1.26–1.29]) and women (HR, 1.19 [95% CI, 1.18–1.20]) were more likely to die than their married counterparts. When the researchers adjusted the analysis for insurance status and neighborhood socioeconomic status, unmarried men still were at a 22% increased risk for death (HR, 1.22) and women were at a 15% increased risk (HR, 1.15).

“Men and women appear to benefit differentially from marriage, with women benefitting more financially and men benefitting more socially,” the researchers wrote. “Furthermore, the adoption of ‘healthier’ lifestyle habits that often accompanies marriage may be greater among men than women. Thus, the greater survival benefits observed in men may reflect sex-specific differences in the relative contributions of the underlying mechanisms.”

For unmarried women, the increased risk was relatively similar whether women were never married, separated, divorced, or widowed. However, for men, the highest risk was among men who were never married.

The researchers also discovered evidence of a relationship between unmarried patients with lower levels of insurance and living in higher socioeconomic status neighborhoods having the highest level of risk for death.

“Our findings may be related to the higher out-of-pocket costs for uninsured individuals, with those financial challenges compounded by the higher costs of living in higher socioeconomic status neighborhoods,” the researchers wrote.