Spousal support and survival outcomes in colorectal cancer: the role of social determinants in oncologic prognosis
10.3760/cma.j.cn115396-20250221-00039
- VernacularTitle:伴侣支持与结直肠癌生存结局：社会因素在肿瘤预后中的角色
- Author:
Xiaobao YANG
1
Author Information
1. 首都医科大学附属北京朝阳医院疝和腹壁外科，北京 100043
- Keywords:
Colorectal neoplasms;
Marital status;
Social support;
Survival analysis
- From:
International Journal of Surgery
2025;52(4):238-244
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the impact of spousal support on the prognosis of colorectal cancer patients.Methods:Based on the US SEER database, a total of 110 652 patients with primary colorectal cancer were collected from 2010 to 2017, including 59 247 males and 51 405 females, aged 67 (54, 73) years, and the age range was 18 to 85 years. According to partner support status, they were married ( n=64 638), unmarried ( n=20 445), divorced or separated ( n=13 027), and widowed ( n=12 542). The primary outcome was cancer-specific survival (CSS). Non-normally distributed continuous variables were reported as M( Q1, Q3) and compared using the Kruskal-Wallis test. Categorical variables were described as cases and percentage (%) and analyzed via chi-square test. Kaplan-Meier survival curves and COX proportional hazards models were applied to systematically evaluate associations between gender, age, race, partner support status, and CSS. Results:Married patients exhibited the highest 5-year CSS (Stage I: 95.9%; Stage IV: 16.5%), while widowed patients had the poorest outcomes (Stage I: 91.4%; Stage IV: 12.9%; all P<0.001). After adjusting for confounders, lack of partner support (single/divorced/separated/widowed) remained an independent risk factor for CSS ( P<0.001). Subgroup analysis revealed no survival difference between widowed and single/divorced patients after age matching ( P>0.05). Among stage Ⅰ-Ⅱ widowed patients, males showed significantly worse prognosis than females ( P<0.05). Conclusions:Spousal support constitutes a critical social determinant of colorectal cancer prognosis. Integrating social support assessment into oncology care pathways and implementing targeted interventions for partnership-deprived populations are imperative to mitigate survival inequities.
