The effect of marital status on stage, treatment, and survival of cancer patients.
The effect of marital status on stage, treatment, and survival of cancer patients.
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DOI：
10.1001/jama.1987.03400210067027
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发表时间：
1987-12
期刊：
影响因子：
--
通讯作者：
J. Goodwin;W. Hunt;C. Key;J. Samet
中科院分区：
文献类型：
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作者：
J. Goodwin;W. Hunt;C. Key;J. Samet
婚姻状况对癌症患者的诊断、治疗和生存的影响在27,779例癌症病例的人群数据中进行了研究。未婚癌症患者的总生存率降低（相对危险度为1.23; 95%置信限为1.19 ~ 1.28）。我们确定了三个互补的解释未婚者生存较差。首先，未婚者更有可能在区域或遥远的阶段被诊断出来（比值比，1.19; 95%置信限，1.12至1.25）。调整分期后，未婚者更有可能未接受癌症治疗（比值比，1.43; 95%置信限，1.31至1.55）。最后，在调整了分期和治疗后，未婚者的生存率仍然较差。以前的研究表明，未婚者的总体死亡率下降。对于癌症，我们的研究结果表明，结婚对总生存率的有利影响是次要的，在诊断，治疗选择和治疗反应的几个步骤中的有益影响。
The effects of marital status on the diagnosis, treatment, and survival of patients with cancer were examined in population-based data on 27,779 cancer cases. Unmarried persons with cancer had decreased overall survival (relative hazard, 1.23; 95% confidence limits, 1.19 to 1.28). We identified three complementary explanations for the poorer survival of the unmarried persons. First, unmarried persons were more likely to be diagnosed at a regional or distant stage (odds ratio, 1.19; 95% confidence limits, 1.12 to 1.25). After adjustment for stage, unmarried persons were more likely to be untreated for cancer (odds ratio, 1.43; 95% confidence limits, 1.31 to 1.55). Finally, after adjustment for stage and treatment, unmarried persons still had poorer survival. Previous studies have demonstrated that unmarried persons have decreased overall mortality. For cancer, our results suggest that the favorable consequence of being married on overall survival is secondary to the beneficial effects at several steps in the diagnosis, choice of treatment, and response to treatment.