title: Gender differences in associations between cancer-related problems and relationship dissolution among cancer survivors.
abstract: Research suggests that a cancer diagnosis predicts marital dissolution more strongly for women survivors than men, but there is a paucity of research on potential processes underlying this vulnerability. The present cross-sectional study examined whether specific cancer-related problems were associated with the odds of relationship breakup following diagnosis and whether these relationships differed between male and female cancer survivors.
  
  
  
  A national cross-sectional quality of life study assessed self-reported cancer-related problems and relationship change among survivors who were either 2, 6, or 10 years post-diagnosis (n = 6099).
  
  
  
  Bivariate analyses indicated that cancer-related problems (e.g., emotional distress) were greater for divorced/separated survivors compared to those with intact relationships and were greater for women versus men. Logistic regressions indicated that for both male and female survivors, lower income, younger age, and longer time since diagnosis were associated with greater odds of divorce or separation after diagnosis (ORs > 2.14, p < .01). For women only, greater emotional distress (OR = 1.14, p < 0.01) and employment and financial problems (OR = 1.23, p < 0.0001) were associated with greater odds of post-diagnosis divorce or separation. For men only, fear of cancer recurrence was associated with greater odds of divorce or separation (OR = 1.32, p < 0.001).
  
  
  
  Female and male survivors differed in the extent to which emotional or financial/employment problems attributed to the cancer diagnosis were associated with the likelihood of reporting relationship dissolution.
  
  
  
  Although directions of causality could not be ascertained, results suggest the possibility that helping male and female cancer survivors cope with specific cancer-related problems may benefit the quality and stability of their relationships with significant others following diagnosis.
authors.affiliation: Department of Sociology and Criminal Justice, Kennesaw State University, 402 Bartow Avenue NW, Kennesaw, GA, 30144, USA. cgheorgh@kennesaw.edu.
authors.forename: Cristina
authors.initials: C
authors.lastname: Stephens
authors.affiliation: American Cancer Society, 250 Williams Street NW, Atlanta, GA, 30303, USA.
authors.forename: J Lee
authors.initials: JL
authors.lastname: Westmaas
authors.affiliation: Bagwell College of Education, Secondary and Middle Program, Kennesaw State University, Kennesaw, GA, USA.
authors.forename: Jihye
authors.initials: J
authors.lastname: Kim
authors.affiliation: American Cancer Society, 250 Williams Street NW, Atlanta, GA, 30303, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Cannady
authors.affiliation: American Cancer Society, 250 Williams Street NW, Atlanta, GA, 30303, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Stein
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D003430:Cross-Sectional Studies; D004243:Divorce / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life; D012737:Sex Factors; D017741:Survivors / Q000523:psychology*; D014481:United States / Q000453:epidemiology
keywords: Cancer-related problems; Gender; Marital status; Survivorship