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.