Adults living alone had a 32% higher risk of cancer death than those living with others, according to study results from researchers at the American Cancer Society. For men, the risk was even greater—38%—compared to a 30% higher risk for women. The association between living alone and cancer mortality risk was highest among non-Hispanic White adults and those with higher education levels than for racial/ethnic minorities and adults with lower education levels. The study by Lee et al was published in the journal Cancer.
According to the study, in 2020, there were about 38 million solo households in the United States compared to just 7 million single households in 1960. Adults living alone were more likely to be older; male; non-Hispanic White or non-Hispanic Black; have incomes below the federal poverty level; have serious distress or severe obesity; smoke cigarettes; and consume alcohol.
Methodology
The researchers pooled 1998 to 2019 data for 473,648 adults aged 18 to 64 years at enrollment from the National Health Interview Survey linked to the National Death Index. Up to 22 years of follow-up were used to calculate hazard ratios for the association between living alone and cancer mortality.
Results
The researchers found compared to adults living with others, adults living alone were at a higher risk of cancer death in the age-adjusted model (hazard ratio [HR] = 1.32, 95% confidence interval [CI] = 1.25–1.39) and after additional adjustments for multiple sociodemographic characteristics and cancer risk factors (HR = 1.10, 95% CI = 1.04–1.16). Age-adjusted models stratified by sex, poverty level, and educational attainment showed similar associations between living alone and cancer mortality, but the association was stronger among non-Hispanic White adults (HR = 1.33, 95% CI = 1.25–1.42) than non-Hispanic Black adults (HR = 1.18, 95% CI = 1.05–1.32; P value for difference < .05) and did not exist in other racial/ethnic groups.
These associations were attenuated, but persisted in fully adjusted models among men (HR = 1.13, 95% CI = 1.05–1.23), women (HR = 1.09, 95% CI = 1.01–1.18), non-Hispanic White adults (HR = 1.13, 95% CI = 1.05–1.20), and adults with a college degree (HR = 1.22, 95% CI = 1.07–1.39).
“In this nationally representative study in the United States, adults living alone were at a higher risk of cancer death in several sociodemographic groups,” concluded the study authors.
Clinical Significance
“These results reflect the need for more resources and appropriate training for clinicians, integrated screening for living alone and social isolation, and more research to identify and implement interventions that could reduce adverse effects of living alone and social isolation,” said lead study author Hyunjung Lee, PhD, MS, MPP, MBA, Principal Scientist, Cancer Disparity Research at the American Cancer Society, in a statement. “Some examples include patient navigation programs for this population to increase uptake of and adherence to cancer screening, timely diagnosis, treatment, and attendance of medical appointments, and the inclusion of this group among high-priority groups for services based on screenings for the[ir] health-related social needs.”
Disclosure: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.
