title: Keeping it in the family: the impact of marital status and next of kin on cancer treatment and survival.
abstract: BACKGROUND
  This study examines the impact of marriage and next of kin identity on timing of diagnosis, treatment, and survival in cancer patients.
  
  
  METHODS
  Retrospective review of patients with 5 solid tumor types treated at an academic medical center from 2002 to 2012. Exposures of interest were marriage status at time of diagnosis and familial relationship with next of kin (NOK). Association with overall survival determined via Cox regressions and with early diagnosis (stage I to II) and receipt of surgery via logistic regressions.
  
  
  RESULTS
  Marriage was not associated with early diagnosis for any cancer type. After adjustment, being married was associated with significantly higher odds of receiving surgery only for pancreatic cancer and with improved survival for breast and lung cancers. Having a nuclear relationship with NOK was not associated with any outcomes.
  
  
  CONCLUSIONS
  Marriage status was associated with improved outcomes for certain cancers whereas familial relationship with NOK was not.
authors.affiliation: Surgical Outcomes Analysis and Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Mariam F
authors.initials: MF
authors.lastname: Eskander
authors.affiliation: Surgical Outcomes Analysis and Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Emily F
authors.initials: EF
authors.lastname: Schapira
authors.affiliation: Surgical Outcomes Analysis and Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Lindsay A
authors.initials: LA
authors.lastname: Bliss
authors.affiliation: Surgical Outcomes Analysis and Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Nikki M
authors.initials: NM
authors.lastname: Burish
authors.affiliation: Surgical Outcomes Analysis and Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Tadikonda
authors.affiliation: Surgical Outcomes Analysis and Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Sing Chau
authors.initials: SC
authors.lastname: Ng
authors.affiliation: Surgical Outcomes Analysis and Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. Electronic address: jftseng@bidmc.harvard.edu.
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Tseng
mesh_terms: D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D001900:Boston / Q000453:epidemiology; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D042241:Early Diagnosis; D005190:Family; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D017533:Marital Status; D009369:Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018714:Radiotherapy, Adjuvant / Q000706:statistics & numerical data; D012042:Registries; D012189:Retrospective Studies; D012944:Social Support
chemical_list: D018931:Antineoplastic Agents, Hormonal
keywords: Cancer; Marriage; Outcomes; Social connectedness; Survival