What's Love Got to do with it? Marital status and survival of head and neck cancer

• Published in: European journal of cancer care Vol. 28; no. 4; pp. e13022 - n/a
• Main Authors: Osazuwa‐Peters, Nosayaba, Christopher, Kara M., Cass, Lauren M., Massa, Sean T., Hussaini, Adnan S., Behera, Anit, Walker, Ronald J., Varvares, Mark A.
• Format: Journal Article
• Language: English
• Published: England Hindawi Limited 01-07-2019
• Subjects: Aged; Alcohols; Cancer; cancer survivorship; Cohort analysis; Cohort Studies; Female; Hazards; Head & neck cancer; head and neck cancer; Head and Neck Neoplasms - mortality; Humans; Male; Marital status; Marital Status - statistics & numerical data; Middle Aged; Nursing; Oral cavity; Patients; Proportional Hazards Models; retrospective cohort study; Retrospective Studies; Social interactions; social support; Statistical models; Surgery; Survival; Survivor; Tobacco; retrospective cohort study; social support; marital status; cancer survivorship; head and neck cancer
• ISSN: 0961-5423; 1365-2354
• DOI: 10.1111/ecc.13022

Objective
To determine whether marital status independently predicts survival in a head and neck cancer (HNC) survivor population.
Methods
In this retrospective cohort study, we analysed data from 460 adult patients (59.31 ± 11.42) years diagnosed with HNC at an academic tertiary referral centre between 1997 and 2012. Cox proportional hazards model estimated the effect of marital status on survival.
Results
Our study had 73% men, and 82.2% were Whites. We found an association between marital status and HNC survival. Unmarried HNC patients had a 66% increase in hazard of death compared to married patients (aHR = 1.66, 95% CI = 1.23–2.23). This was after controlling for sociodemographic variables (age, race, sex and health insurance status), social habits (tobacco and alcohol), primary anatomical subsite (oral cavity, oropharyngeal, laryngeal and others), stage at presentation (early vs. late stage) and treatment modality (surgery, surgery with adjuvant therapies, other single modality therapy and palliative care).
Conclusions
Being married confers survival advantage for HNC survivors. Our finding underscores the need to recognise this aspect of survivorship. Social support should be considered part of standard care for managing HNC. There may also be need to develop other support mechanisms, especially for unmarried HNC survivors.