The Impact of Marital Status on Stage at Diagnosis and Survival of Female Patients with Breast and Gynecologic Cancers: A Meta-Analysis

Abstract

Background: The aim of this meta-analysis is to evaluate the effect of marital status on the stage at diagnosis and survival of female patients with breast and gynecologic cancers.Methods: A systematic literature search was conducted on electronic databases (PubMed, Cochrane and EMBASE) till March 31, 2020. Publications investigating the association of marital status with stage at diagnosis and/or cancer-specific mortality (CSM) and/or overall survival (OS) in female patients with breast or gynecologic cancers were retrieved. After studies were selected according to inclusion criteria, data extraction, quality assessment and data analysis were performed. Results: 55 articles were eligible for inclusion, consisting of 1195773 female cancer patients with breast, vulvar, cervical, endometrial and ovarian cancers. Unmarried female cancer patients had higher odds of being diagnosed at later stage [odds ratio (OR) = 1.28, 95% confidence interval (CI): 1.22-1.36)] and worse survival outcomes in CSM [hazard ratio (HR) = 1.22, 95% CI: 1.16-1.28] and OS (HR = 1.20, 95% CI: 1.14-1.25). This estimate did not vary by level of social support, number of adjustment factors, or between America and Europe. Conclusions: Being married is associated with timely diagnosis and favorable prognosis in most women’s cancers. Unmarried female cancer patients have a higher risk of late-stage diagnosis and worse survival outcomes than the married. Greater concern shall be demonstrated towards unmarried female cancer patients. Furthermore, the impact of lacking economic and emotional support on survival outcomes in unmarried female cancer patients deserves particular attention.

Thyroid cancer and its associated factors: A population‐based case‐control study

“…In contrast, single people, due to less emotional support, are more depressed, more stressed and have lower quality of life. 41 Evidence suggests that hypertension is a side effect of treatment of TC. 42 Also, fat abnormalities due to thyroid dysfunction affect the arteries and thus increase blood pressure.…”