Decreased cancer survival in individuals separated at time of diagnosis: critical period for cancer pathophysiology?
Decreased cancer survival in individuals separated at time of diagnosis: critical period for cancer pathophysiology?
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DOI：
10.1002/cncr.24547
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发表时间：
2009-11-01
期刊：
影响因子：
6.2
通讯作者：
Johnstone, Peter A. S.
中科院分区：
文献类型：
--
作者：
Sprehn, Gwen C.;Chambers, Joanna E.;Saykin, Andrew J.;Konski, Andre;Johnstone, Peter A. S.
It long has been recognized that married patients have improved cancer survival when compared to unmarried patients. This has been postulated as being due to increased support, potentially leading to better compliance with therapy. Conversely, some data exist pointing to a relationship between marital discord and decreased immunity. We examined whether unmarried patients have a different prognosis by whether they are (a) never married; (b) divorced; (c) widowed; or (d) separated at time of diagnosis. The public access data of the Surveillance, Epidemiology and End Results (SEER) registry were queried for cancer survival across all 17 registries between 1973 and 2004. Data were last updated by SEER in April, 2007. Records of 3.79 million patients were included in the analysis. We specifically analyzed 5- and 10-year relative survival (5yRS, 10yRS), defined as observed survival divided by observed survival of an age-, race- and gender-matched population without disease, for all cancer patients by marital status, with specific subset analyses as indicated. Among unmarried patients, those separated at time of diagnosis had the lowest survival, followed by widowed, divorced, and never married patients. 5- and 10-year relative survival of separated patients was 72% and 64% that of married patients, respectively. This relationship persists when data are analyzed by gender. Separated marital status is associated with a significant decrement in cancer survival, even in comparison with other unmarried groups. While other socioeconomic variables could contribute to this phenomenon, further research into the immunologic correlates of the acutely stressful condition of marital separation should be conducted.
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影响因子：
3.3
作者：
KIECOLTGLASER, JK;KENNEDY, S;GLASER, R
通讯作者：
GLASER, R
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3.3
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KIECOLTGLASER, JK;MALARKEY, WB;GLASER, R
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3.3
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Davidson, RJ;Kabat-Zinn, J;Sheridan, JF
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Sheridan, JF
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3.3
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KIECOLTGLASER, JK;FISHER, LD;GLASER, R
通讯作者：
GLASER, R
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3.3
作者：
LEVY, SM;HERBERMAN, RB;KIRKWOOD, J
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KIRKWOOD, J