Partner status and survival after cancer: A competing risks analysis
Author(s)
Dasgupta, Paramita
Turrell, Gavin
Aitken, Joanne F
Baade, Peter D
Year published
2016
Metadata
Show full item recordAbstract
Objective: The survival benefits of having a partner for all cancers combined is well recognized, however
its prognostic importance for individual cancer types, including competing mortality causes, is less clear.
This study was undertaken to quantify the impact of partner status on survival due to cancer-specific and
competing mortality causes.
Methods: Data were obtained from the population-based Queensland Cancer Registry on 176,050 incident
cases of ten leading cancers diagnosed in Queensland (Australia) from 1996 to 2012. Flexible parametric
competing-risks models were used to estimate cause-specific hazards and cumulative ...
View more >Objective: The survival benefits of having a partner for all cancers combined is well recognized, however its prognostic importance for individual cancer types, including competing mortality causes, is less clear. This study was undertaken to quantify the impact of partner status on survival due to cancer-specific and competing mortality causes. Methods: Data were obtained from the population-based Queensland Cancer Registry on 176,050 incident cases of ten leading cancers diagnosed in Queensland (Australia) from 1996 to 2012. Flexible parametric competing-risks models were used to estimate cause-specific hazards and cumulative probabilities of death, adjusting for age, stage (breast, colorectal and melanoma only) and stratifying by sex. Results: Both unpartnered males and females had higher total cumulative probability of death than their partnered counterparts for each site. For example, the survival disadvantage for unpartnered males ranged from 3% to 30% with higher mortality burden from both the primary cancer and competing mortality causes. The cause-specific age-adjusted hazard ratios were also consistent with patients without a partner having increased mortality risk although the specific effect varied by site, sex and cause of death. For all combined sites, unpartnered males had a 46%,18% and 44% higher risk of cancer-specific, other cancer and non-cancer mortality respectively with similar patterns for females. The higher mortality risk persisted after adjustment for stage. Conclusions: It is important to better understand the mechanisms by which having a partner is beneficial following a cancer diagnosis, so that this can inform improvements in cancer management for all people with cancer.
View less >
View more >Objective: The survival benefits of having a partner for all cancers combined is well recognized, however its prognostic importance for individual cancer types, including competing mortality causes, is less clear. This study was undertaken to quantify the impact of partner status on survival due to cancer-specific and competing mortality causes. Methods: Data were obtained from the population-based Queensland Cancer Registry on 176,050 incident cases of ten leading cancers diagnosed in Queensland (Australia) from 1996 to 2012. Flexible parametric competing-risks models were used to estimate cause-specific hazards and cumulative probabilities of death, adjusting for age, stage (breast, colorectal and melanoma only) and stratifying by sex. Results: Both unpartnered males and females had higher total cumulative probability of death than their partnered counterparts for each site. For example, the survival disadvantage for unpartnered males ranged from 3% to 30% with higher mortality burden from both the primary cancer and competing mortality causes. The cause-specific age-adjusted hazard ratios were also consistent with patients without a partner having increased mortality risk although the specific effect varied by site, sex and cause of death. For all combined sites, unpartnered males had a 46%,18% and 44% higher risk of cancer-specific, other cancer and non-cancer mortality respectively with similar patterns for females. The higher mortality risk persisted after adjustment for stage. Conclusions: It is important to better understand the mechanisms by which having a partner is beneficial following a cancer diagnosis, so that this can inform improvements in cancer management for all people with cancer.
View less >
Journal Title
Cancer Epidemiology
Volume
41
Subject
Oncology and carcinogenesis
Health services and systems
Public health