A U.S. population-based study across demographic groups and cancer types found that ever-married adults consistently had a lower cancer risk compared with never-married individuals. Published in Cancer Research Communications, these findings suggest that marital status may serve as a valuable social indicator for cancer risk stratification and prevention, according to Pinheiro et al.
“Whereas some variation may reflect selection into marriage, the magnitude and site-specific patterns of association suggest that marital status stratifies cancer risk through cumulative social and behavioral pathways, including those relevant to infection-related and lifestyle-associated cancers,” the investigators commented.
Study Details
According to the investigators, marriage has been consistently linked to earlier cancer detection and improved survival; however, they wrote of its unclear relationship with cancer incidence, providing the rationale for the present study.
The analysis focused on data from the Surveillance, Epidemiology, and End Results program covering 12 states, representing 103.7 million individuals in 2022 (31.1% of the U.S. population) and encompassing all major racial and ethnic groups. Adults aged at least 30 years were included, with denominators obtained from the American Community Survey (2015–2022).
Age-adjusted cancer incidence rates were calculated, and negative binomial regression was applied to estimate incidence rate ratios (IRRs) comparing never-married with ever-married adults. Analyses were stratified by sex, age group, and cancer site.
Key Findings
Cancer incidence was higher among never-married adults, with IRRs of 1.68 (95% confidence interval [CI] = 1.53–1.84) in men and 1.85 (95% CI = 1.68–2.03) in women; this trend appeared to persist across most major cancer sites and racial and ethnic groups (IRR range = 1.62 [White men] to 1.96 [Black men]). Never-married Black men were found to have the highest cancer incidence, whereas among ever-married men, this group had lower rates than their White counterparts.
Among men, anal cancer showed the highest site-specific IRR (5.04), and among women, cervical cancer had the highest IRR (2.64). Pronounced marital differences were seen in gynecologic and infection-, tobacco-, and alcohol-related cancers, the investigators wrote, whereas disparities were smaller for breast, thyroid, and prostate cancers.
The investigators concluded, “Taken together, these findings highlight marital status as a prominent and consistent social stratifier of cancer incidence in the contemporary United States.”
“In the context of declining marriage rates, delayed or forgone childbearing, and shifting social norms, never-married adults may represent a vulnerable group for cancer prevention and early detection,” they added. “Integrating marital status into cancer surveillance and risk stratification frameworks may enhance identification of at-risk populations and inform more targeted prevention strategies.”
Paulo S. Pinheiro, PhD, of Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, is the corresponding author of the article in Cancer Research Communications.
Disclosure: The study was funded by the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. The study authors reported no conflicts of interest.
