Key result
Unmarried status linked to ~92% higher risk of cardiovascular death in female breast cancer patients.
Why the study?
The influence of marital status on cardiovascular death risk in patients with breast cancer remained unclear.
Does unmarried status increase the risk of cardiovascular death compared to married status in female patients with breast cancer?
Cohort (n=182,666)
Yes
Does unmarried status increase the risk of cardiovascular death compared to married status in female patients with breast cancer?
Unmarried status—particularly widowhood—is an independent social predictor of nearly doubled cardiovascular mortality risk in women with breast cancer, highlighting the need for targeted psychosocial support and cardiovascular surveillance in these patients.
Answers are grounded in this paper and cite their sources.
Unmarried breast cancer patients may warrant closer cardiovascular monitoring; extends prior observational data but leaves causality and interventions open.
Background: The influences of marital status on cardiovascular death risk in patients with breast cancer remained unclear. This study aimed to evaluate the associations of different marital status with cardiovascular death risk in patients with breast cancer. Methods: A total of 182,666 female breast cancer patients were enrolled in this study from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2014, and was divided into two groups: married (N=107,043) and unmarried (N=75,623). A 1:1 propensity score matching (PSM) was applied to reduce inter-group bias between the two groups. Competing-risks model was used to assess the associations between different marital status and cardiovascular death risk in patients with breast cancer. Results: After PSM, marital status was an independent predictor for cardiovascular death in patients with breast cancer. Unmarried condition was associated with increased cardiovascular death risk than married condition among breast cancer patients [unadjusted model: hazard ratio (HR) =2.012, 95% confidence interval (CI): 1.835-2.208, P<0.001; Model 1: HR =1.958, 95% CI: 1.785-2.148, P<0.001; Model 2: HR =1.954, 95% CI: 1.781-2.144, P<0.001; Model 3: HR =1.920, 95% CI: 1.748-2.107, P<0.001]. With the exception of separated condition (adjusted HR =0.886, 95% CI: 0.474-1.658, P=0.705), further unmarried subgroups analysis showed that the other three unmarried status were associated with increased cardiovascular death risk as follows: single (adjusted HR =1.623, 95% CI: 1.421-1.853, P<0.001), divorced (adjusted HR =1.394, 95% CI: 1.209-1.608, P<0.001), and widowed (adjusted HR =2.460, 95% CI: 2.227-2.717, P<0.001). In particularly, widowed condition showed the highest cardiovascular death risk in all 4 unmarried subgroups. Conclusions: Unmarried condition (e.g., single, divorced and widowed) was associated with elevated cardiovascular death risk compared with their married counterparts in patients with breast cancer, suggesting that more attention and humanistic care should be paid to unmarried breast cancer patients (especially the widowed patients) in the management of female breast cancer patients.
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Guan et al. (2022) conducted a cohort in Female breast cancer (n=182,666). Unmarried status (single, separated, divorced, widowed) vs. Married status (legal marriage) was evaluated on Cardiovascular death (death attributable to heart disease, atherosclerosis, cerebrovascular disease, aortic aneurysm and dissection, other arterial diseases, and hypertension without heart disease) (HR 1.920, 95% CI 1.748-2.107, p=<0.001). Unmarried status was associated with a significantly higher risk of cardiovascular death compared to married status in female breast cancer patients after propensity score matching (HR 1.920, P<0.001).
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