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Symptom Management and Supportive Care

Does Marital Status Impact Survival and Quality of Life in Patients with Non-Small Cell Lung Cancer? Observations from the Mayo Clinic Lung Cancer Cohort

^aDivision of Medical Oncology, ^bCancer Center Statistics, ^cDepartment of Surgery, ^dDepartment of Psychiatry and Psychology, ^eDivision of Pulmonary Medicine, and ^fDivision of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA

Key Words. Lung cancer • Marital status • Survival • Quality of life

Correspondence: Aminah Jatoi, M.D., Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA. Telephone: 507-284-3902; Fax: 507-284-1803; e-mail: jatoi.aminah{at}mayo.edu

Disclosure: No potential conflicts of interest were reported by the authors, planners, reviewers, or staff managers of this article.

Purpose. Previous studies have found that marriage is associated with longer survival and better quality of life among lung cancer patients. The present study used the Mayo Clinic Lung Cancer Cohort to re-examine this issue.

Methods. In total, 5,898 non-small cell lung cancer (NSCLC) patients, who had available information on marital status and who had been enrolled in the Mayo Clinic Lung Cancer Cohort (MCLCC), were the focus of this study. Patients had extensive baseline and follow-up data on cancer stage, cancer treatment, and prognostic factors. All patients had been followed within the MCLCC with at least annual confirmation of vital status and patient-reported quality of life (the Lung Cancer Symptom Scale and the Linear Analogue Scales of Assessment).

Results. The numbers of patients who were married, single, divorced, and widowed at the time of cancer diagnosis were 4,457 (76%), 265 (4%), 440 (7%), and 736 (12%), respectively. No statistically significant difference in survival was observed among these four groups, even after adjusting for a variety of prognostic factors, such as age, gender, and tumor stage. However, exploratory analyses suggested that widowed and divorced patients received less aggressive cancer therapy, and certain patient subgroups, such as stage IA widowed patients, had a shorter survival. Divorced patients reported greater financial concerns, and married and widowed patients reported greater spirituality and better social support.

Conclusion. This study did not observe differences in survival or quality of life based on marital status at the time of diagnosis of NSCLC, but subgroup analyses appear to suggest findings worthy of further exploration.