Mortality is higher among unmarried patients with cancer than married patients, and the highest mortality rates were observed among unmarried men, according to a population-based study reported at the American Association of Cancer Research 2015 Annual Meeting. Socioeconomic factors and health insurance did not fully account for this sex-related difference.
“When we went into this study, we assumed that socioeconomic and insurance factors would affect results, but these factors did not fully explain our results. We found the highest mortality among unmarried males at the time of their cancer diagnosis. These results confirm the stronger protective effect of being married on survival among men than women with cancer,” explained senior author of this poster, Maria Elena Martinez, PhD, of the University of California San Diego.
“The results suggest that unmarried status should be targeted as a risk factor. Unmarried cancer patients need more social support and treatment, especially unmarried males who are more likely to die,” she stated.
The study was conducted to determine whether mortality differences between married and unmarried patients with cancer are explained by neighborhood socioeconomic status or insurance status and the extent to which this varies by sex.
The study population, based on the California Cancer Registry, included patients diagnosed from 2000 to 2009 with a first invasive cancer that was 1 of the 10 cancers with highest mortality. There were 393,470 males and 389,697 females. Patients were followed through December 31, 2012. During that time, there were 204,007 deaths in males and 182,600 in females.
Neighborhood (ie, block group) socioeconomic status was determined by Census 2000 and American Community Survey 2007-2011 data, using a composite index based on 7 variables reflecting education, income, employment, poverty, occupation, rent, and housing value.
Unmarried patients were more likely than married to represent the youngest age group (under age 30 years) and the oldest (80+ years). They were more likely to have lower socioeconomic status, be uninsured and have public insurance, be diagnosed at a later stage, and not be treated with radiation and chemotherapy. Males who were unmarried were 30% more likely to die than their married counterparts, whereas females were only 20% more likely to die if unmarried. These associations were marginally stronger in higher than lower socioeconomic neighborhoods, and after adjusting for insurance status, were slightly lower. The association varied by sex and cancer site.
Gomez SL, Canchola A, Hurley S, et al. Lower mortality among married cancer patients: How much of the effect is explained by socioeconomic and health insurance status? Presented at: American Association of Cancer Research Annual Meeting 2015; April 18-22, 2015; Philadelphia, PA. Abstract 885.