Prediagnosis social support, social integration, living status, and colorectal cancer mortality in postmenopausal women from the women's health initiative

Abstract

Background We evaluated associations between perceived social support, social integration, living alone, and colorectal cancer (CRC) outcomes in postmenopausal women. Methods The study included 1431 women from the Women's Health Initiative who were diagnosed from 1993 through 2017 with stage I through IV CRC and who responded to the Medical Outcomes Study Social Support survey before their CRC diagnosis. We used proportional hazards regression to evaluate associations of social support (tertiles) and types of support, assessed up to 6 years before diagnosis, with overall and CRC‐specific mortality. We also assessed associations of social integration and living alone with outcomes also in a subset of 1141 women who had information available on social ties (marital/partner status, community and religious participation) and living situation. Results In multivariable analyses, women with low (hazard ratio [HR], 1.52; 95% CI, 1.23‐1.88) and moderate (HR, 1.21; 95% CI, 0.98‐1.50) perceived social support had significantly higher overall mortality than those with high support (P [continuous] < .001). Similarly, women with low (HR, 1.42; 95% CI, 1.07‐1.88) and moderate (HR, 1.28; 95% CI, 0.96‐1.70) perceived social support had higher CRC mortality than those with high social support (P [continuous] = .007). Emotional, informational, and tangible support and positive interaction were all significantly associated with outcomes, whereas affection was not. In main‐effects analyses, the level of social integration was related to overall mortality (P for trend = .02), but not CRC mortality (P for trend = .25), and living alone was not associated with mortality outcomes. However, both the level of social integration and living alone were related to outcomes in patients with rectal cancer. Conclusions Women with low perceived social support before diagnosis have higher overall and CRC‐specific mortality.

Perspectives of cancer patients during the COVID‐19 outbreak in Israel: The long‐term implications on support and well‐being in an exploratory qualitative study

“…Social support is regarded as a complex construct that has long been suggested to have direct and ameliorating effects on patients' well‐being and emotional adjustment to cancer (Kroenke et al, 2020 ). Williams et al ( 2019 ) found that 67% of 1460 adult cancer patients reported the need for social support, half reported a need for emotional support and 47% expressed the need for physical support.…”

[Retracted] Epidemiological Analysis and Prognosis of Conjunctival Cancer in the Past Twenty Years: A Population‐Based Retrospective Study Using SEER Data

“…Our study is the first to demonstrate that being single, divorced, or widowed is a risk factor associated with primary site-labeled conjunctival and corneal cancer incidence. Prior studies have primarily only examined the relationship between marital status and other forms of cancer including colorectal cancer [ 22 ], neuroendocrine tumors [ 23 ], and gastric adenocarcinoma [ 24 ] in retrospective [ 25 ] analyses or in prospective analyses [ 26 ]. While several studies have assessed the relationship between marital status and patient prognosis, conclusions have varied significantly among studies.…”

Early-Onset Colorectal Cancer Survival Differences and Potential Geographic Determinants Among Men and Women in Utah

“…Increased CRC survival among those who are married, have a life partner, or have other forms of high social support is likely attributable to psychosocial factors, including the availability of emotional support, assistance in monitoring health status, and aid in coping with treatment and shaping preventive health behaviors. [46][47][48] Moreover, individuals with established support systems often experience reduced cortisol levels associated with chronic psychological stress, thereby reducing various inflammatory markers that may provide the opportunity for precancerous cells to grow and flourish. 32,49,50 Although social support has a positive impact on health and health-promoting behaviors, more interventional research is warranted to focus on increasing the survival benefit associated with EOCRC for single or never-married individuals, and for patients with poor social relationships.…”