Abstract
The objective of this study is to examine the impact of marital status on incidence of metastasis at diagnosis, receipt of surgery, and cause‐specific survival (CSS) in patients with gastric cancer (GC). Research data is extracted from The Surveillance, Epidemiology, and End Results (SEER) database, and 18,196 patients diagnosed with GC from 2004 to 2010 are involved. Effects of marital status on incidence of metastasis at diagnosis, receipt of surgery, and CSS are determined using multivariable logistic regression and multivariable Cox regression models, as appropriate. Single GC patients have a higher incidence of metastasis at diagnosis than married patients, while the differences between divorced/separated patients or widowed patients and married patients are not significant. Among those without distant metastasis, single patients, divorced/separated patients, and widowed patients are much less likely to accept surgery compared with married patients. Finally, in the whole group of 18,196 GC patients, single patients, divorced/separated patients, and widowed patients have shorter CSS compared with married patients, even in each of the TNM stage. Marriage had a protective effect against undertreatment and cause‐specific mortality (CSM) in GC. Spousal support may contribute to higher rate of surgery receipt and better survival in patients with GC.
Highlights
The incidence of gastric cancer (GC) ranks the fourth in men and fifth in women among malignancies, and affects more than one million people annually [1]
We find that marriage has a protective effect on GC patients
Married GC patients have a lower incidence of metastasis at diagnosis than single patients
Summary
The incidence of gastric cancer (GC) ranks the fourth in men and fifth in women among malignancies, and affects more than one million people annually [1]. The prognosis for patients with GC is poor with the 5-year relative survival rates being 29% from 2003 to 2009 in the United States [2]. Studies indicated that unmarried patients were at higher risk of presentation with metastatic cancer, undertreatment, and shorter survival in various cancer types [3,4,5,6,7,8,9,10,11,12]. Mixed [13,14,15,16] or no significant [17,18,19] associations between marital status and cancer survival were reported as well. With regard to GC, a recent large population-based study indicates that individuals who are divorced, widowed, or lived alone are at increased risk for esophagogastric cancer [20]. Little is known about the association between marital status and outcomes of GC
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