Association of marital status with cardiovascular death risk in patients with lung cancer: A population-based study

Background

To investigate the association of marital status on cardiovascular death risk in lung cancer patients.

Methods

Using data from the Surveillance, Epidemiology, and End Results (SEER) database in the United States from 2011 to 2015 (N = 118,293), the association between marital status and cardiovascular death (CVD) risk in patients with lung cancer was assessed by competing-risks regression models.

Results

Unmarried status was associated with increased risk of cardiovascular death in lung cancer patients [hazard ratio (HR)  =  1.398, 95 % confidence interval (CI): 1.268–1.542], which remained significant even after adjusting for potential covariates (HR = 1.407, 95 % CI: 1.276–1.551). Further unmarried subgroups analysis showed that the different unmarried status were associated with increased cardiovascular death risk as follows: single (HR = 1.397, 95 % CI: 1.236–1.1.580), separated (HR = 1.630, 95 % CI: 1.153–2.305), divorced (HR = 1.318, 95 % CI: 1.158–1.500), and widowed (HR = 1.561, 95 % CI: 1.393–1.749). Further subgroup analysis by sex revealed that compared to male lung cancer patients with married, CVD risk was significant increased in their counterparts with widowed (adjusted HR = 1.509, 95 % CI: 1.291–1.764, P<0.001), single (adjusted HR = 1.361, 95 % CI: 1.168–1.585, P<0.001) and divorced (adjusted HR = 1.353, 95 % CI: 1.177–1.555, P<0.001) rather than those with separated. However, similar phenomena was only observed in female lung cancer patients with widowed (adjusted HR = 1.414, 95 % CI: 1.220–1.640, P<0.001) and single (adjusted HR = 1.438, 95 % CI: 1.195–1.730, P<0.001).

Conclusion

Unmarried status was associated with increased cardiovascular death risk in patients with lung cancer, which highlighted that more attention and humanistic/supportive care should be offered to unmarried lung cancer patients for improving the prognosis.