Effects of marital status on survival in patients with colorectal cancer.

Abstract

3628 Background: Demographic factors such as marital status have been shown to have differential effects on cancer outcomes. It has been shown that married patients have higher 5-year survival rates compared with unmarried patients with colorectal cancer (CRC). However, most of these studies looked at patients diagnosed prior to 2015. This study compares the survival trends between 2000–2010 and 2011–2021 and analyzes marital status associations with stage at diagnosis. Methods: Patients with CRC diagnosed between 2000 and 2021 were identified in the SEER database and stratified by marital status (single, separated/divorced/widowed (SDW), and married). 5-year survival rates with 95% confidence intervals were calculated for each marital status group across three periods: 2000–2010, 2011–2021, and 2000–2021. Kaplan-Meier survival analysis was used to compare survival outcomes across these variables. Disease severity was classified into three stages: localized, regional, and distant. The distribution of patients across disease stages is reported as the proportion of individuals within each marital status group at each cancer stage. Results: Overall survival was statistically different amongst patients with different marital statuses (p < 0.01). Our results show that the highest 5-year overall survival rate is seen in married individuals at 62.1% (61.9% - 62.2%), followed by single individuals at 53.0% (52.6% - 53.3%), and SDW individuals at 44.6% (44.3% - 44.8%). Overall survival improved over time across all marital groups when comparing the 2000–2010 and 2011–2021 periods. For married individuals, 5-year overall survival rate increased from 61.2% (61.0%–61.4%) to 63.1% (62.9%–63.4%). Similarly, survival improved for single individuals (51.1% [50.6%–51.6%] to 54.5% [54.0%–54.9%]) and for SDW individuals (43.8% [43.5%–44.1%] to 45.7% [45.3%–46.1%]). Our results show that married individuals were most commonly diagnosed with localized cancer compared with single and SDW individuals (41.8% vs 36.5% vs 39.0%, p < 0.01), SDW individuals with regional cancer compared with single and married individuals (38.3% vs 37.06% vs 37.5%, p < 0.01) and single individuals with distant disease compared with married and SDW individuals (26.4% vs 20.69% vs 22.69%, p < 0.01). Conclusions: Marital status significantly impacts CRC survival, with married individuals having higher survival rates than single or SDW patients. This suggests that social support may contribute to improved outcomes, although it is important to note that the higher survival rates may be associated with earlier diagnosis in married individuals. These findings highlight the potential need for additional support services for single and SDW individuals, underscoring the importance of considering marital status when addressing demographic disparities in cancer care.