HealthDay News — Unmarried patients are at significantly higher risk of presentation with metastatic cancer, undertreatment and cancer-related death, according to researchers.

Married patients were less likely to present with metastatic disease (adjusted odds ratio 0.83, P<0.001), more likely to receive definitive therapy (aOR 1.53, P<0.001), and less likely to die as a result of their cancer (aOR 0.80, P<0.001), compared to unmarried patients, Ayal A. Aizer, MD, from Harvard University in Boston, and colleagues reported in the Journal of Clinical Oncology.

The results remained significant after adjusting for demographics, stage and treatment.

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The researchers analyzed data from the Surveillance, Epidemiology and End Results program and identified 1,260,898 patients diagnosed with lung, colorectal, breast, pancreatic, prostate, liver/intrahepatic bile duct, non-Hodgkin’s lymphoma, head/neck, ovarian or esophageal cancer from 2004 through 2008.

Analysis of each individual cancer showed similar significant associations for all end points. For all outcomes, the benefit associated with marriage was greater in males than females (P<0.001 in all cases).

The survival benefit associated with marriage was larger than the published survival benefit of chemotherapy for prostate, breast, colorectal, esophageal and head/neck cancers.

“This study highlights the potentially significant impact that social support can have on cancer detection, treatment and survival,” the researchers wrote.

In an accompanying editorial, David W. Kissane, MD, MPM, FRANZCP, FAChPM, of Memorial Sloan-Kettering Cancer Center and Weill Cornell Medical, praises Aizer et al for recommending oncologists recognize single status “as a warning sign for the existence of poor social support.”

“The time has arrived for comprehensive cancer centers to make communication skills training a mandated component of fellowship training in oncology,” Kissane wrote. “For psycho-oncology and supportive services to be able to address the needs of patients with cancer and their families, adequate staffing levels with psychiatrists, psychologists, and social workers are vital to be able to deliver group, couple, and family therapy services alongside individual care.”


  1. Aizer AA et al. J Clin Oncol. 2013; doi:10.1200/JCO.2013.49.648.
  2. Kissane DW. J Clin Oncol. 2013; doi: 10.1200/JCO.2013.51.5080.