Effect of marriage on outcomes for elderly patients with head and neck cancer

Background Beneficial effects of marriage on cancer outcomes have been observed for many cancers, but oral cavity and pharyngeal cancers have never been examined. Methods We used the National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results (SEER) Program linked with Medicare records to identify 9403 elderly patients (age ≥66 years) with oral cavity and pharyngeal cancers. We used a propensity score analysis to estimate differences in proportions (p_d) between married and unmarried patients on stage, treatment, and survival. Results For oral cavity cancers, a larger proportion of married patients presented with earlier stage (p_d = 0.05; 95% confidence interval [CI], 0.02-0.08), were treated with surgery (p_d = 0.06; 95% CI, 0.03-0.08), and survived 1 year (p_d = 0.04; 95% CI, 0.01-0.06). Similar results were found for pharyngeal cancers for stage (p_d = 0.04; 95% CI, 0.01-0.06), treatment with chemotherapy and radiation (p_d = 0.04; 95% CI, 0.01-0.07), and 1-year survival (p_d = 0.01; 95% CI, 0.08-0.16). Conclusion Marriage is associated with earlier stage, aggressive treatment, and superior survival for patients with oral cavity and pharyngeal cancers.