ArticleCancer causes & control : CCC2026
Social disruption after cancer: longitudinal changes in marital status, residence, and income among over 450,000 cancer patients.
Article in Cancer causes & control : CCC, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe impact of cancer extends beyond clinical outcomes, often disrupting interpersonal relationships and living situations. Although these social factors are important for survivorship, little is known about how marital status, residential urbanicity, and income change over time for cancer patients.
methodsUsing SEER 17, we obtained data from 457,058 adults diagnosed with multiple primary cancers from 2000 to 2021 and evaluated changes in marital status, urbanicity, and household income between the first and last recorded diagnoses. Analyses were stratified by follow-up interval (short: 2-5, long: > 5 years). Marital status change was evaluated among patients who were married at the first cancer diagnosis (n = 255,939), and changes in urbanicity and household income were evaluated as secondary analyses among patients who remained married from first to last diagnosis (n = 214,956). Logistic regressions adjusted for demographic and clinical factors were used to estimate odds ratios and 95% confidence intervals.
resultsAmong patients married at the first diagnosis, 5% became not married (divorced/separated/single) and 11% were widowed; rates were higher in women (6% not married; 16% widowed) than men (4; 7%). Among patients who remained married from the first to the last diagnosis, 5% changed urbanicity (1.5% more rural; 3.4% more urban) and 26% changed income (15% increase; 10% decrease). NHB patients had > twofold higher odds of being unmarried (not married or widowed) and income decrease compared to non-Hispanic Whites. Hispanic patients also had elevated odds of unmarried, while Non-Hispanic Asian/Pacific Islander patients had lower odds of income decrease.
conclusionsCancer diagnoses are associated with notable social and economic disruptions, disproportionately affecting women and vulnerable racial/ethnic populations. This study provides the first large-scale analysis of how marital status, residence, and income evolve, highlighting the need to address social determinants of health in survivorship care.
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