Evidence map›Paper›PMID 35639382›Full record

SynthesisJAMA network open2022

Association of Marital Status With Total and Cause-Specific Mortality in Asia.

Chi Yan Leung, Hsi-Lan Huang, Sarah Krull Abe, Eiko Saito, Md Rashedul Islam, Md Shafiur Rahman, Ai Ikeda, Norie Sawada, Akiko Tamakoshi, Yu-Tang Gao and 33 more

Open access · goldAbstract readMeta-Analysis
In one paragraph

Synthesis in JAMA network open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 3 pooled it
8.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 3 syntheses or guidelines pooled it, 57 citations in OpenAlex.

  1. Pooled it
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  11. Observational
  12. Article
  13. Marital Failure and Subsequent Heart Failure: A Prospective Study.Journal of the American Heart Association · 2025
    Article
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  15. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

43 authors at 20 institutions in 7 countries.

Chi Yan LeungDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Hsi-Lan HuangDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Sarah Krull AbeDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Eiko SaitoInstitute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan.
Md Rashedul IslamDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Md Shafiur RahmanDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Ai IkedaJuntendo University, School of Medicine, Department of Public Health, Tokyo, Japan.
Norie SawadaDivision of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Akiko TamakoshiDepartment of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan.
Yu-Tang GaoDepartment of Epidemiology, Shanghai Cancer Institute, Shanghai, China.
Woon-Puay KohHealthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Xiao-Ou ShuDivision of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee.
Ritsu SakataRadiation Effects Research Foundation, Hiroshima, Japan.
Ichiro TsujiTohoku University Graduate School of Medicine, Sendai, Japan.
Jeongseon KimGraduate School of Science and Policy, National Cancer Center, Gyeonggi-do, Republic of Korea.
Sue K ParkDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Chisato NagataDepartment of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
San-Lin YouSchool of Medicine and Big Data Research Center, Fu Jen Catholic University, New Taipei City, Taiwan.
Jian-Min YuanDivision of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
Myung-Hee ShinDepartment of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Wen-Harn PanInstitute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.
Shoichiro TsuganeDivision of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Takashi KimuraDepartment of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan.
Wanqing WenDivision of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee.
Hui CaiDivision of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee.
Kotaro OzasaRadiation Effects Research Foundation, Hiroshima, Japan.
Sanae MatsuyamaTohoku University Graduate School of Medicine, Sendai, Japan.
Seiki KanemuraTohoku University Graduate School of Medicine, Sendai, Japan.
Yumi SugawaraTohoku University Graduate School of Medicine, Sendai, Japan.
Aesun ShinDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Keiko WadaDepartment of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
Chien-Jen ChenGenomics Research Center, Academia Sinica, Taipei, Taiwan.
Renwei WangDivision of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
Yoon-Ok AhnDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Habibul AhsanDepartment of Public Health Sciences, University of Chicago, Chicago, Illinois.
Paolo BoffettaStony Brook Cancer Center, Stony Brook University, Stony Brook, New York.
Kee Seng ChiaSaw Swee Hock School of Public Health, National University of Singapore, Singapore.
Keitaro MatsuoDivision Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
You-Lin QiaoCenter for Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Nathaniel RothmanDivision of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland.
Wei ZhengDivision of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee.
Daehee KangCollege of Medicine, Seoul National University, Seoul, Republic of Korea.
Manami InoueDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Seoul National University · KRTohoku University · JPVanderbilt University Medical Center · USGifu University · JPRadiation Effects Research Foundation · JPThe University of Tokyo · JPAgency for Science, Technology and Research · SGChinese Academy of Medical Sciences & Peking Union Medical College · CNDivision of Cancer Epidemiology and GeneticsFu Jen Catholic University · TWGenomics Research Center, Academia Sinica · TWHamamatsu University School of Medicine · JPHokkaido Institute of Public Health · JPHokkaido University · JPJuntendo University · JPNagoya University · JPNational Cancer Center · KRNational Center for Global Health and Medicine · JPNational Health Research Institutes · TWNational University Health System · SG

Funding

Prospective studies of cancer etiology and prevention in Shanghai and SingaporeR01CA144034 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI YUAN, JIAN-MIN · 2010 to 2014
$7.0M
DIETARY FACTORS IN THE ETIOLOGY OF CANCER IN SHANGHAIR01CA043092 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI YUAN, JIAN-MIN · 1987 to 2006
$5.8M
THE SINGAPORE COHORT STUDY OF DIET AND CANCERR01CA080205 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI YUAN, JIAN-MIN · 1999 to 2009
$5.3M
Cancer epidemiology cohorts in Shanghai and Singapore UM1CA182876 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI YUAN, JIAN-MIN · 2014 to 2018
$4.3M
The Singapore Chinese Health StudyU01CA182876 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI YUAN, JIAN-MIN · 2019 to 2019
$150k
NCI NIH HHS R01 CA043092NCI NIH HHS R01 CA080205NCI NIH HHS R01 CA144034NCI NIH HHS U01 CA182876NCI NIH HHS UM1 CA182876
6 · The paper itself

Abstract

Importance: Marital status has been shown to be associated with mortality, but evidence in Asian populations is limited. Objective: To examine the association of marital status with total and cause-specific mortality. Design, Setting, and Participants: This cohort study included individual participant data from 16 prospective studies in the Asia Cohort Consortium conducted between 1963 and 2015. Asian participants with complete information on marital and vital status were included. Study-specific hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards model and then pooled using a random-effects meta-analysis. The analysis began in February 2021 and ended in August 2021. Exposures: Marital status. Main Outcomes and Measures: All-cause and cause-specific mortality. Results: Of 623 140 participants (326 397 women [52.4%] and 296 743 men [47.6%]; mean [SD] age, 53.7 [10.2] years; mean [SD] follow-up time, 15.5 [6.1] years), 123 264 deaths were ascertained. Compared with married individuals, those who were unmarried had pooled HRs of 1.15 (95% CI, 1.07-1.24) for total mortality, 1.12 (95% CI, 1.03-1.22) for cerebrovascular disease mortality, 1.20 (95% CI, 1.09-1.31) for coronary heart disease mortality, 1.17 (95% CI, 1.07-1.28) for circulatory system diseases mortality, 1.06 (95% CI, 1.01-1.11) for cancer mortality, 1.14 (95% CI, 1.05-1.23) for respiratory diseases mortality, and 1.19 (95% CI, 1.05-1.34) for external causes of death. Positive associations with total mortality were also observed for those who were single (HR, 1.62; 95% CI, 1.41-1.86), separated (HR, 1.35; 95% CI, 1.13-1.61), divorced (HR, 1.38; 95% CI, 1.13-1.69), and widowed (HR, 1.09; 95% CI, 1.04-1.13). In subgroup analyses, the positive association persisted across baseline health conditions, and the risk of death was more pronounced among men or people younger than 65 years. Conclusions and Relevance: This large pooled cohort study of individual participant data provides strong evidence that being unmarried, as well as belonging to the unmarried subcategories, was positively associated with total and cause-specific mortality. Investment of targeted social support services might need to be considered in light of the mortality differences between married and unmarried individuals.

Indexed as

Cohort StudiesAsiaCause of DeathFemaleHumansMaleMarital StatusMiddle AgedProspective Studies

Identifiers

PMID35639382
PMCPMC9157263
OpenAlexW4281723950

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.