Dr Martínez and colleagues confirmed that “all-cause mortality was higher in unmarried patients than in married patients, but there was a significant variation by race/ethnicity.”

Among males, adjusted hazard ratios ranged from 1.24 (95% CI, 1.23 – 1.26) for non-Hispanic whites to 1.11 (95% CI, 1.07 – 1.15) in Asians/Pacific Islanders; among females, the range was from 1.17 (95% CI, 1.15 – 1.18) in non-Hispanic whites to 1.07 (95% CI, 1.04 – 1.11) for Asians/Pacific Islanders.

“All-cause mortality associated with unmarried status compared with married status was higher in US-born Asians/Pacific Islanders and Hispanic men and women relative to their foreign-born counterparts,” they found. “These results suggest that factors responsible for the adverse effects of not being married tend to have a greater effect on overall mortality as immigrant groups acculturate to the United States.”

Dr Martínez told Cancer Therapy Advisor that “compared to married patients, unmarried individuals were less likely to receive surgery and radiation therapy. When we accounted for these treatment factors in the statistical models, the differences in survival between married and unmarried patients persisted.”

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The authors pointed out that “future research should pursue the identification of factors underlying these associations to inform targeted interventions for unmarried cancer patients.”

A separate study conducted using the same data found that “the worse survival of unmarried than married cancer patients appears to be minimally explained by differences in economic resources.”2


  1. Martínez ME, Anderson K, Murphy JD, et al. Differences in marital status and mortality by race/ethnicity and nativity among California cancer patients [published online ahead of print April 11, 2016]. Cancer. doi: 10.1002/cncr.29886.
  2. Gomez SL, Hurley S, Canchola AJ, et al. Effects of marital status and economic resources on survival after cancer: a population-based study [published online ahead of print April 11, 2016]. Cancer. doi: 10.1002/cncr.29885.