Being married enables most patients with cancer to live longer than their unmarried peers. While this had been known for some time, a recently published study by Scarlett Lin Gomez, PhD, of the Cancer Prevention Institute of California, and María Elena Martínez, PhD, of the University of California, San Diego School of Medicine, and their colleagues furthers the discussion.1
The team suggests that one reason for the discrepancy might be because married patients are more likely to obtain their diagnoses early on in the disease process, when treatment is usually more effective. In addition, married patients are more likely to have healthier lifestyles, including more physical activity and more healthful dietary habits, than their single counterparts. They are more apt to take advantage of cancer screening opportunities, and when cancer is identified, their treatment is more successful. However, this study goes beyond the social aspect of survival to focus on “the impact of economic resources as a contributing factor for marriage-associated survival differences.”1
800 000 PATIENTS—10 CANCER SITES
For this project, the research team utilized population-based data from the California Cancer Registry for first primary invasive cancers in males and females older than 18 years. This gave them information on approximately 800 000 adults with invasive cancer diagnosed in the years 2000 to 2009. Patients were followed through 2012.
Cancer sites for males were prostate, lung and bronchus (lung cancer), colon, non-Hodgkin lymphoma (NHL), bladder, liver and intrahepatic bile duct (liver and IBD), leukemia, pancreas, stomach, and esophagus. For females, the sites were breast; lung; colon; corpus and uterus, not otherwise specified (uterus); NHL; ovary; pancreas; leukemia; brain and other nervous system (brain); and liver and IBD.
Patient characteristics included marital status, age, address and stage at diagnosis, year of diagnosis, race/ethnicity, sex, histology, first course of treatment (surgery, radiation, and/or systemic hormone agents), as well as primary and secondary payment sources. In terms of payment sources, the researchers coded health insurance status hierarchically as no insurance; any public, military, or any Medicaid/Medi-Cal (including Medicare/Medicaid) insurance; private insurance only; Medicare only or Medicare and private insurance; and unknown.