The influence of marital status on the stage at diagnosis, treatment, and survival of older women with breast cancer
The influence of marital status on the stage at diagnosis, treatment, and survival of older women with breast cancer
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DOI：
10.1007/s10549-005-3702-4
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发表时间：
2005-09-01
影响因子：
3.8
通讯作者：
Goodwin, JS
中科院分区：
文献类型：
--
作者：
Osborne, C;Ostir, GV;Goodwin, JS
研究表明婚姻状况与健康之间存在关联，但这种联系尚未得到充分探究。我们的目的是研究婚姻状况对老年乳腺癌女性的诊断、治疗和生存的影响，以及社会经济地位、教育水平和合并症在解释这些关联中可能起到的潜在作用。采用关联的医疗保险和美国国家癌症研究所监测、流行病学及最终结果癌症登记处数据进行回顾性队列研究。样本包括32268名65岁及以上在1991年至1995年期间被诊断患有乳腺癌的女性。截至1998年可获取的信息允许进行3年的随访。结果显示，未婚女性更有可能被诊断为乳腺癌II - IV期，而非I期和原位癌（比值比1.17；95%置信区间1.12，1.23）。被诊断为I期或II期乳腺癌的未婚女性接受确定性治疗的可能性更低（比值比1.24；95%置信区间1.17，1.31）。即使在控制了诊断时的癌症分期和大小以及所接受的治疗后，未婚女性死于乳腺癌的风险仍然增加（风险比1.25；95%置信区间1.14，1.37）。社会经济变量和合并症对婚姻状况与生存之间的关系影响甚微。老年已婚女性在被诊断患有乳腺癌后死亡风险降低。已婚女性所享有的许多健康益处可能源于增加的社会支持和社交网络。
Research indicates an association between marital status and health but this link has not been thoroughly explored. Our goal was to examine the association of marital status on the diagnosis, treatment, and survival of older women with breast cancer and the potential role socioeconomic status, education level, and comorbidities may play in explaining these associations. Retrospective cohort study using linked Medicare and National Cancer Institute Surveillance, Epidemiology, and End Results cancer registry. The sample consisted of 32,268 women aged 65 years and older who received a diagnosis of breast cancer from 1991 to 1995. Information available through 1998 allowed for 3 years of follow-up. Results showed that unmarried women were more likely to be diagnosed with breast cancer stage II-IV versus stage I and in situ (OR 1.17; CI95 1.12, 1.23). Unmarried women diagnosed with stage I or II breast cancer were less likely to receive definitive therapy (OR 1.24; CI95 1.17, 1.31). Even after controlling for cancer stage and size at diagnosis and treatment received, unmarried women were at an increased risk of death from breast cancer (HR 1.25; CI95 1.14, 1.37). Socioeconomic variables and comorbidity had little impact on the relationship between marital status and survival. Older married women were at decreased risk for mortality after a diagnosis of breast cancer. Many of the health benefits enjoyed by married women are likely derived from increased social support and social networks.