Impact of Marital Status and Race on Survival for Patients With Colon Cancer: An Analysis of Data From the Surveillance, Epidemiology, and End-Results (SEER) Program

Purpose/Objective(s): This study included 165,226 individuals diagnosed with colorectal cancer between 1988 and 2001. Colorectal cancer cases were identified from 16 population-based registries of the National Cancer Institute’s Surveillance, Epidemiology, and End Results program. Materials/Methods: Survival probabilities were compared among white and black patients. Kaplan-Meier curves and proportional hazard ratios from Cox regression analysis were calculated accounting for marital status, age, gender, stage at diagnosis and year of diagnosis. Patients lacking complete information were excluded from analysis. Results: Multivariate analysis demonstrated that older age, male gender, non-recent year of diagnosis, and advanced stage at diagnosis were associated with worse survival. Black race independently predicted for a worse survival compared with whites. Marital status was a greater predictor of survival when analyzed in conjunction with race: compared to married white patients, black single/separated/divorced (unmarried) and black married patients were found to have hazard ratios (HR) of 1.63 (1.56-1.71) and 1.21 (1.17-1.25), respectively. While stage I patients experienced better survival, when compared to white married patients, the HR for black unmarried and black married patients was 2.11 (1.84-2.41) and 1.35 (1.241.47), respectively. Conclusions: Marital status and race are independent predictors of colorectal cancer survival. Additional strategies must be defined that address the social factors that account for disparities in cancer outcome. Author Disclosure: A. Blackstock: E. Research Grant; NIH/NCI P30 CA012197-36. B. Lally: None. S. Isom: None. E. Paskett: None.