Changes over time in the effect of marital status on cancer survival.
Changes over time in the effect of marital status on cancer survival.
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随着时间的流逝，婚姻状况对癌症存活的影响。
DOI：
10.1186/1471-2458-11-804
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发表时间：
2011-10-14
影响因子：
4.5
通讯作者：
Syse A
中科院分区：
文献类型：
--
作者：
Kravdal H;Syse A
未婚者的全因死亡率和特定原因死亡率高于已婚者。未婚人群的癌症存活率也较差。最近，一些研究发现，随着时间的推移，未婚者的过度全因死亡率有所增加，某些特定的死亡原因也显示出同样的模式。这项研究的目的是调查是否有一个类似的变化，随着时间的推移，婚姻状况的差异，癌症的生存。使用涵盖整个挪威人口的登记数据，估计了1970-2007年诊断患有癌症的44万多名30-89岁妇女和男子的癌症死亡的离散时间风险回归模型。在超过200万人-年的暴露期间，分析了超过20万例癌症死亡。与已婚者相比，未婚者的死亡率一直在稳步上升，尤其是老年人。在老年妇女中，未婚者的死亡率高于已婚者，有迹象表明，寡妇的死亡率高于已婚者。然而，离婚男女的超额死亡率一直保持稳定。没有明显的原因可以解释未婚者的劣势越来越大。这可能是由于诊断时的总体健康状况相对较差，或者是因为在一个可能变得不那么团结的社会中，伙伴关系的保护作用更大，或者是因为婚姻的选择更积极。或者，这可能与待遇方面的差别越来越大有关。当今复杂的癌症治疗方案对于从未结过婚的人来说可能更难遵循，因此可能有必要采取更专门针对和适应广大从未结过婚的患者亚群的医疗保健干预措施。
Rates of all-cause and cause-specific mortality are higher among unmarried than married individuals. Cancer survival is also poorer in the unmarried population. Recently, some studies have found that the excess all-cause mortality of the unmarried has increased over time, and the same pattern has been shown for some specific causes of death. The objective of this study was to investigate whether there has been a similar change over time in marital status differences in cancer survival. Discrete-time hazard regression models for cancer deaths among more than 440 000 women and men diagnosed with cancer 1970-2007 at age 30-89 were estimated, using register data encompassing the entire Norwegian population. More than 200 000 cancer deaths during over 2 million person-years of exposure were analyzed. The excess mortality of the never-married compared to the married has increased steadily for men, in particular the elderly. Among elderly women, the excess mortality of the never-married compared to the married has increased, and there are indications of an increasing excess mortality of the widowed. The excess mortality of divorced men and women, however, has been stable. There is no obvious explanation for the increasing disadvantage among the never-married. It could be due to a relatively poorer general health at time of diagnosis, either because of a more protective effect of partnership in a society that may have become less cohesive or because of more positive selection into marriage. Alternatively, it could be related to increasing differentials with respect to treatment. Today's complex cancer therapy regimens may be more difficult for never-married to follow, and health care interventions directed and adapted more specifically to the broad subgroup of never-married patients might be warranted.
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影响因子：
2.4
作者：
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通讯作者：
Kravdal, O
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