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Differences in Marital Status and Cancer Mortality by Race/Ethnicity and Nativity Explored

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Key Points

  • Non-Hispanic white bachelors experienced the worst outcome, with a 24% higher mortality rate than their married counterparts.
  • Unmarried non-Hispanic white women had a 17% increase in mortality compared to those who were married, whereas single female Asian/Pacific Islanders experienced a 6% increase in cancer death compared to wedded counterparts.
  • Unmarried patients born outside of the United States experienced better survivorship rates compared to those born in the United States. There was a significant difference among women of Hispanic descent as well as males and females of Asian/Pacific Islander descent who were born in the United States compared to their foreign-born counterparts.

Previous studies have shown that married patients with cancer fare better than unmarried patients with cancer, surviving more often and longer. In a new study, published by Martínez et al in Cancer, researchers at University of California, San Diego, School of Medicine reported that the benefits of being married vary by race and ethnicity.

Differences in Mortality Rates

Male non-Hispanic white bachelors were found to be experiencing the worst outcome. This group had a 24% higher mortality rate than their married counterparts.

Unmarried women also had higher mortality than married women, but the difference was less significant than among men. Unmarried non-Hispanic white women had a 17% increase in mortality compared to those who were married, whereas single female Asian/Pacific Islanders experienced a 6% increase in cancer death compared to wedded counterparts.

“Oncologists should be aware that an increase in cancer mortality is a real outcome among unmarried individuals,” said María Elena Martínez, PhD, UC San Diego Moores Cancer Center Sam M. Walton Endowed Chair for Cancer Research and lead author of the study. “Physicians treating unmarried patients should ask if there is someone within their social network available to help the individual physically and emotionally during treatment. More attention should be paid to this consistent and adverse health effect of being unmarried.”

The number of unmarried adults in the United States is growing, from 10% in 1960 to 23% in 2012 among men and 8% to 17% among women. Researchers say an increase in cancer mortality is also likely to continue rising. They suggest further work to study the association between marriage and cancer mortality to help inform future decisions that may reduce cancer disparities.

Effects of Nativity

In the study, comprehensive data from the California Cancer Registry were used to study 393,470 men and 389,697 women. In addition to the difference based on race and ethnicity, researchers found variation based upon place of birth. Unmarried patients born outside of the United States experienced better survivorship rates compared to those born in the United States. There was a significant difference among women of Hispanic descent as well as males and females of Asian/Pacific Islander descent who were born in the United States compared to their foreign-born counterparts.

“The results suggest that the more acculturated you become to U.S. culture, the more it impacts cancer survivorship,” said Dr. Martínez, Co-Director of the Reducing Cancer Disparities research program at Moores Cancer Center. “Our hypothesis is that non-Hispanic whites don't have the same social network as other cultures that have stronger bonds with family and friends outside of marriage. As individuals acculturate they tend to lose those bonds. It's also been shown that women seek out help for health concerns more frequently than men, and women tend to remind spouses to see their physicians and live a healthy lifestyle.”

The data did not include information about comorbidities, changes in marital status after a cancer diagnosis, or on unmarried couples living together, which may differ among different race/ethnic groups.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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