Abstract
Globally, cancer is the second leading cause of death. Loneliness has been suggested as a risk factor for cancer mortality. However, connections between loneliness, social isolation, and cancer are poorly understood. In our longitudinal study (mean follow-up: 20.44 years) of 2570 middle-aged men, loneliness, social isolation, and health-related factors were measured at baseline. Cox proportional hazards analysis was used to examine the association between cancer incidence, loneliness, and social isolation. The effect of relationship status on cancer mortality among cancer patients was tested with the Kaplan-Meier method. Loneliness was associated with total cancer incidence after adjustments for tested lifestyle and health-related covariates. Social Isolation was associated with total cancer incidence, except when adjusted for lifestyle, diet, or Human Population Laboratory (HPL) Depression Scale scores. Loneliness was associated with lung cancer incidence, except when adjusted for HPL Depression Scale scores. There was no significant association between social isolation and lung cancer. Neither loneliness nor social isolation were connected with prostate or colorectal cancer. Being single at baseline was associated with worse survival outcomes for cancer patients. Our findings suggest that regardless of the social network size, loneliness among middle-aged men is associated with an increased likelihood of cancer.
Highlights
Cancer is the second leading cause of death, and has already become the most common cause of death in high-income countries (Dagenais et al, 2019; World Health Organization Cancer, 2018)
Loneliness was associated with total cancer incidence even after adjusting for all covariates (Table 2)
Social isolation was associated with total cancer incidence, except when adjusted for lifestyle variables (Model 3), Baltic Sea Diet Score (BSDS) (Model 4), Human Population Laboratory (HPL) Depression Scale scores (Model 6), or when all covariates were included in the model at the same time (Model 9)
Summary
Cancer is the second leading cause of death, and has already become the most common cause of death in high-income countries (Dagenais et al, 2019; World Health Organization Cancer, 2018). While research on the most common cancer risk factors is abundant, knowl edge of the effects of psychosocial factors, such as loneliness and social isolation, is scarce. Cancer incidence has been associated with psychosocial risk factors such as stress, depression, and low social support (Antoni et al, 2006; Lutgendorf and Sood, 2011). After receiving a cancer diagnosis, social support is important in helping the patient to initiate treatment in accordance with the prescribed treatment protocol. In a British study, patients who lived alone received less combination chemotherapy and secondary surgery, suggesting that living alone is an independent risk factor for poor survival in metastatic colorectal cancer (Cav alli-Bjorkman et al, 2012)
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