title: 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.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Medical Oncology, Mayo Clinic, Rochester, MN 55905, USA. jatoi.aminah@mayo.edu
authors.forename: Aminah
authors.initials: A
authors.lastname: Jatoi
authors.forename: Paul
authors.initials: P
authors.lastname: Novotny
authors.forename: Stephen
authors.initials: S
authors.lastname: Cassivi
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Clark
authors.forename: David
authors.initials: D
authors.lastname: Midthun
authors.forename: Christi A
authors.initials: CA
authors.lastname: Patten
authors.forename: Jeff
authors.initials: J
authors.lastname: Sloan
authors.forename: Ping
authors.initials: P
authors.lastname: Yang
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D005260:Female; D006304:Health Status; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D011788:Quality of Life; D015996:Survival Rate; D014481:United States / Q000453:epidemiology