The Influence of Marital Status on the Stage at Diagnosis, Treatment, and Survival of Older Women with Breast Cancer

Abstract

Research indicates an association between marital status and health but this link has not been thoroughly explored. Our goal was to examine the association of marital status on the diagnosis, treatment, and survival of older women with breast cancer and the potential role socioeconomic status, education level, and comorbidities may play in explaining these associations. Retrospective cohort study using linked Medicare and National Cancer Institute Surveillance, Epidemiology, and End Results cancer registry. The sample consisted of 32,268 women aged 65 years and older who received a diagnosis of breast cancer from 1991 to 1995. Information available through 1998 allowed for 3 years of follow-up. Results showed that unmarried women were more likely to be diagnosed with breast cancer stage II-IV versus stage I and in situ (OR 1.17; CI95 1.12, 1.23). Unmarried women diagnosed with stage I or II breast cancer were less likely to receive definitive therapy (OR 1.24; CI95 1.17, 1.31). Even after controlling for cancer stage and size at diagnosis and treatment received, unmarried women were at an increased risk of death from breast cancer (HR 1.25; CI95 1.14, 1.37). Socioeconomic variables and comorbidity had little impact on the relationship between marital status and survival. Older married women were at decreased risk for mortality after a diagnosis of breast cancer. Many of the health benefits enjoyed by married women are likely derived from increased social support and social networks.

Appropriateness of early breast cancer management in relation to patient and hospital characteristics: a population based study in Northern Italy

“…The lower probability of unmarried women with breast cancer receiving a definitive therapy is not new and has been interpreted as an effect of reduced family support and weaker social networks [19].…”

Marital status and survival in patients with gastric cancer

“…Marriage may have a protective effect on prognosis of cancer patients. Studies indicated that unmarried patients were at higher risk of presentation with metastatic cancer, undertreatment, and shorter survival in various cancer types 3, 4, 5, 6, 7, 8, 9, 10, 11, 12. Mixed 13, 14, 15, 16 or no significant 17, 18, 19 associations between marital status and cancer survival were reported as well.…”

Predictors of Breast Cancer Screening Uptake: A Pre Intervention Community Survey in Malaysia

“…Although marital status have been commonly identified by various studies (Goodwin et al, 1987;Osborne et al, 2005;Kravdal and Syse, 2011) as a positive factor in earlier cancer diagnosis and better survival, local studies (Parsa and Kandiah, 2010;Rosmawati, 2010) to date have not established any significant link between marriage and uptake of breast cancer screening. Attention should be given as the role of social support in improving screening behaviour needs to be further clarified.…”