title: Effect of marriage on outcomes for elderly patients with head and neck cancer.
abstract: BACKGROUND
  Beneficial effects of marriage on cancer outcomes have been observed for many cancers, but oral cavity and pharyngeal cancers have never been examined.
  
  
  METHODS
  We used the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) Program linked with Medicare records to identify 9403 elderly patients (age ≥66 years) with oral cavity and pharyngeal cancers. We used a propensity score analysis to estimate differences in proportions (pd ) between married and unmarried patients on stage, treatment, and survival.
  
  
  RESULTS
  For oral cavity cancers, a larger proportion of married patients presented with earlier stage (pd = 0.05; 95% confidence interval [CI], 0.02-0.08), were treated with surgery (pd = 0.06; 95% CI, 0.03-0.08), and survived 1 year (pd = 0.04; 95% CI, 0.01-0.06). Similar results were found for pharyngeal cancers for stage (pd = 0.04; 95% CI, 0.01-0.06), treatment with chemotherapy and radiation (pd = 0.04; 95% CI, 0.01-0.07), and 1-year survival (pd = 0.01; 95% CI, 0.08-0.16).
  
  
  CONCLUSIONS
  Marriage is associated with earlier stage, aggressive treatment, and superior survival for patients with oral cavity and pharyngeal cancers.
authors.affiliation: Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Schaefer
authors.forename: Matthew Z
authors.initials: MZ
authors.lastname: Wilson
authors.forename: David
authors.initials: D
authors.lastname: Goldenberg
authors.forename: Heath
authors.initials: H
authors.lastname: Mackley
authors.forename: Wayne
authors.initials: W
authors.lastname: Koch
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Hollenbeak
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D003131:Combined Modality Therapy; D016208:Databases, Factual; D018572:Disease-Free Survival; D055088:Early Detection of Cancer; D005260:Female; D015577:Geriatric Assessment; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D008393:Marriage / Q000523:psychology*; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000628:therapy; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000523:psychology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D018426:SEER Program; D015996:Survival Rate; D016896:Treatment Outcome; D035862:Vulnerable Populations
keywords: cancer stage; cancer survival; cancer treatment; head and neck cancer; marital status