Long‐term population‐based marriage rates among adult survivors of childhood cancer in Britain

Abstract

The objectives of this study were to assess the number of adult survivors of childhood cancer who ever married and the factors influencing marriage, compare observed marriages to those expected from the general population, and assess age at marriage and influencing factors. The data is based on the British Childhood Cancer Survivor Study (BCCSS), which is a populationbased cohort of 18,119 individuals who were diagnosed with childhood cancer between 1940 and 91 and survived at least 5 years. Fourteen thousand five hundred thirty-nine were alive, aged at least 16 years and eligible to receive a postal questionnaire, which ascertained marriage status. Thirty-four percent of 9,954 survivors had married. Survivors with the following characteristics: males, CNS neoplasm, received radiotherapy, diagnosed with mental retardation, registered blind, low social functioning score (calculated from SF-36 health status measure), and achieved the highest level of educational attainment, were less likely to have married than the complementary survivor groups. The deficits in the proportion ever married compared to the general population were mostly between 9 and 18% among males and 7-10% among females. The largest ever married deficits were among male CNS neoplasm survivors aged 30 years or over (29-38%). Age at first marriage among survivors was related to: sex, childhood cancer type, age at diagnosis, chemotherapy, radiotherapy, mental retardation, and level of educational attainment. Regular follow-up for these survivors should address not just physical late-effects of the childhood cancer and treatment, but also psychosocial needs throughout the lifespan of the survivors to help them achieve life events as they occur in the general population. ' 2007 Wiley-Liss, Inc.Key words: childhood cancer; marriage; late effects; survivorship The survival rates for childhood cancer have increased considerably over the last 40 years. 1 The long term physical, psychological and social consequences of childhood cancer and its treatment have been increasingly investigated in survivors. 2,3 One important outcome is the likelihood that survivors form relationships, and in particular live with a partner or marry.Marriage rates have been found to be lower in adult survivors of childhood cancer than those in control subjects. 4-7 Male survivors appear less likely to marry than female survivors. 4,6,8,9 Also survivors of a central nervous system (CNS) neoplasm have been found to marry less frequently than those of other cancer types, 6 especially in males. 4,10,11 Other factors related to the likelihood of marriage among childhood cancer survivors have been suggested, including age at diagnosis, 4,6,9 exposure to radiotherapy, 4 income 4 and educational attainment. 4,8 Adult survivors of childhood cancer have been found to delay marriage 5,12 ; and to be living more often with their parents. 6 In particular, those who had a CNS neoplasm during childhood were found to be older at first marriage than sibling controls. 4 Unfortunately, all previous...

Does cancer affect marriage rates?

“…Whereas skin cancer in both men and women results in elevated marriage rates, brain cancer has a negative impact only in women. This is in contrast to the findings of others [7,8]. Breast and testicular cancer are gender-specific cancer types, closely connected to sexuality and reproduction.…”

“…Cancer in women thus appears to be more harmful for marriage formation than cancer in men, but is mainly a consequence of the strong negative impact of female childhood cancer. This gender difference is disproportionate to findings in some larger childhood cancer studies [7,8,10,15], but not all [16,37]. The effects of the various cancer types are surprisingly inconsistent.…”

“…Cancer's impact on marriage formation rates has only been studied for survivors of childhood cancers. One recent British study described marital status in nearly 10,000 childhood cancer survivors, and found a marriage formation deficit in cancer survivors relative to the general population of around 9-18% for men and around 7-10% for women, and for brain cancer in particular [7]. Preliminary analyses from the US Childhood Cancer Survivor Study, including more than 10,000 survivors, show similar tendencies [8,9], and detailed site-specific analyses on the effects of sarcomas, lymphomas, and leukemia show that cancer survivors are less likely to be married than their healthy siblings [10][11][12][13].…”

Disability, partnership and parenting

“…Byrne et al 1989;Pastore et al 2001;Rauck et al 1999;Frobisher et al 2007). In relation to childhood cancer, it has been suggested that fertility concerns might impact relationship formation; however analysis of the British Childhood Cancer Survivor Study (Frobisher et al 2007) did not support this.…”

Marriage after cancer in older adulthood

“…The impact of cancer on marriage rates has mainly been studied for survivors of childhood cancers, and most studies show slightly reduced marriage rates after cancer, ranging from around 5-20% for men and women [7][8][9][10][11][12][13][14]. In a recently published study, marriage rates among young Norwegian cancer survivors were shown to have become similar to those of the general population with time, although breast and female brain cancer remained associated with reduced rates [15].…”