Skip to main content
British Journal of Cancer logoLink to British Journal of Cancer
. 1995 Jun;71(6):1343–1347. doi: 10.1038/bjc.1995.261

Widowhood and divorce in relation to overall survival among middle-aged Norwegian women with cancer.

A Kvikstad 1, L J Vatten 1, S Tretli 1
PMCID: PMC2033850  PMID: 7779736

Abstract

The aim of the study was to examine the relations between widowhood and divorce and overall survival among women with cancer. All Norwegian women born between 1935 and 1954, and diagnosed with cancer between 1966 and 1990, were followed up until 1991. In all, 14,231 cases were followed up for a median length of approximately 4.5 years (mean = 6 years), and 4311 women died during follow-up. In addition to overall cancer, separate analyses have been made for cancer at specific sites. Widows had a risk of dying which was nearly identical to that of married women for all sites except colorectal cancer, for which widows had a 2-fold increased death rate compared with married women. Divorced women had an overall increased hazard ratio of 1.17 (95% CI 1.07-1.27), which was confined to cancer of the breast, lung and cervix. With few clear exceptions women with children had a better survival than nulliparous women (overall hazard ratio = 0.80, 95% CI 0.74-0.87).

Full text

PDF
1343

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barraclough J., Pinder P., Cruddas M., Osmond C., Taylor I., Perry M. Life events and breast cancer prognosis. BMJ. 1992 Apr 25;304(6834):1078–1081. doi: 10.1136/bmj.304.6834.1078. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bjørge T., Thoresen S. O., Skare G. B. Incidence, survival and mortality in cervical cancer in Norway, 1956-1990. Eur J Cancer. 1993;29A(16):2291–2297. doi: 10.1016/0959-8049(93)90224-4. [DOI] [PubMed] [Google Scholar]
  3. Bowling A. Mortality after bereavement: a review of the literature on survival periods and factors affecting survival. Soc Sci Med. 1987;24(2):117–124. doi: 10.1016/0277-9536(87)90244-9. [DOI] [PubMed] [Google Scholar]
  4. Ewertz M. Breast cancer in Denmark. Incidence, risk factors, and characteristics of survival. Acta Oncol. 1993;32(6):595–615. doi: 10.3109/02841869309092438. [DOI] [PubMed] [Google Scholar]
  5. Farley T. A., Flannery J. T. Late-stage diagnosis of breast cancer in women of lower socioeconomic status: public health implications. Am J Public Health. 1989 Nov;79(11):1508–1512. doi: 10.2105/ajph.79.11.1508. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Forsén A. Psychosocial stress as a risk for breast cancer. Psychother Psychosom. 1991;55(2-4):176–185. doi: 10.1159/000288427. [DOI] [PubMed] [Google Scholar]
  7. Funch D. P., Marshall J. The role of stress, social support and age in survival from breast cancer. J Psychosom Res. 1983;27(1):77–83. doi: 10.1016/0022-3999(83)90112-5. [DOI] [PubMed] [Google Scholar]
  8. Ganz P. A., Lee J. J., Siau J. Quality of life assessment. An independent prognostic variable for survival in lung cancer. Cancer. 1991 Jun 15;67(12):3131–3135. doi: 10.1002/1097-0142(19910615)67:12<3131::aid-cncr2820671232>3.0.co;2-4. [DOI] [PubMed] [Google Scholar]
  9. Goodwin J. S., Hunt W. C., Key C. R., Samet J. M. The effect of marital status on stage, treatment, and survival of cancer patients. JAMA. 1987 Dec 4;258(21):3125–3130. [PubMed] [Google Scholar]
  10. Gove W. R. Sex, marital status, and mortality. AJS. 1973 Jul;79(1):45–67. doi: 10.1086/225505. [DOI] [PubMed] [Google Scholar]
  11. Helsing K. J., Szklo M. Mortality after bereavement. Am J Epidemiol. 1981 Jul;114(1):41–52. doi: 10.1093/oxfordjournals.aje.a113172. [DOI] [PubMed] [Google Scholar]
  12. Hilakivi-Clarke L., Rowland J., Clarke R., Lippman M. E. Psychosocial factors in the development and progression of breast cancer. Breast Cancer Res Treat. 1994 Feb;29(2):141–160. doi: 10.1007/BF00665676. [DOI] [PubMed] [Google Scholar]
  13. Hislop T. G., Waxler N. E., Coldman A. J., Elwood J. M., Kan L. The prognostic significance of psychosocial factors in women with breast cancer. J Chronic Dis. 1987;40(7):729–735. doi: 10.1016/0021-9681(87)90110-x. [DOI] [PubMed] [Google Scholar]
  14. Jacobs S., Ostfeld A. An epidemiological review of the mortality of bereavement. Psychosom Med. 1977 Sep-Oct;39(5):344–357. doi: 10.1097/00006842-197709000-00006. [DOI] [PubMed] [Google Scholar]
  15. Joung I. M., van de Mheen H., Stronks K., van Poppel F. W., Mackenbach J. P. Differences in self-reported morbidity by marital status and by living arrangement. Int J Epidemiol. 1994 Feb;23(1):91–97. doi: 10.1093/ije/23.1.91. [DOI] [PubMed] [Google Scholar]
  16. KRAUS A. S., LILIENFELD A. M. Some epidemiologic aspects of the high mortality rate in the young widowed group. J Chronic Dis. 1959 Sep;10:207–217. doi: 10.1016/0021-9681(59)90003-7. [DOI] [PubMed] [Google Scholar]
  17. Kaprio J., Koskenvuo M., Rita H. Mortality after bereavement: a prospective study of 95,647 widowed persons. Am J Public Health. 1987 Mar;77(3):283–287. doi: 10.2105/ajph.77.3.283. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Kato I., Tominaga S., Ikari A. The role of socioeconomic factors in the survival of patients with gastrointestinal cancers. Jpn J Clin Oncol. 1992 Aug;22(4):270–277. [PubMed] [Google Scholar]
  19. Kogevinas M., Marmot M. G., Fox A. J., Goldblatt P. O. Socioeconomic differences in cancer survival. J Epidemiol Community Health. 1991 Sep;45(3):216–219. doi: 10.1136/jech.45.3.216. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Koskenvuo M., Sarna S., Kaprio J., Lönnqvist J. Cause-specific mortality by marital status and social class in Finland during 1969--1971. Soc Sci Med Med Psychol Med Sociol. 1979 Nov;13A(6):691–697. doi: 10.1016/0271-7123(79)90114-7. [DOI] [PubMed] [Google Scholar]
  21. Kronborg O. Staging and surgery for colorectal cancer. Eur J Cancer. 1993;29A(4):575–583. doi: 10.1016/s0959-8049(05)80155-8. [DOI] [PubMed] [Google Scholar]
  22. Marx J. L. The immune system "belongs in the body". Science. 1985 Mar 8;227(4691):1190–1192. doi: 10.1126/science.3975610. [DOI] [PubMed] [Google Scholar]
  23. Mellström D., Nilsson A., Odén A., Rundgren A., Svanborg A. Mortality among the widowed in Sweden. Scand J Soc Med. 1982;10(2):33–41. doi: 10.1177/140349488201000201. [DOI] [PubMed] [Google Scholar]
  24. Murphy M. F., Goldblatt P. O., Mant D. Marital stability and cancer of the uterine cervix: changing patterns in post-war Britain. Int J Epidemiol. 1993 Jun;22(3):385–392. doi: 10.1093/ije/22.3.385. [DOI] [PubMed] [Google Scholar]
  25. Nayeri K., Pitaro G., Feldman J. G. Marital status and stage at diagnosis in cancer. N Y State J Med. 1992 Jan;92(1):8–11. [PubMed] [Google Scholar]
  26. Neale A. V., Tilley B. C., Vernon S. W. Marital status, delay in seeking treatment and survival from breast cancer. Soc Sci Med. 1986;23(3):305–312. doi: 10.1016/0277-9536(86)90352-7. [DOI] [PubMed] [Google Scholar]
  27. Parkes C. M., Benjamin B., Fitzgerald R. G. Broken heart: a statistical study of increased mortality among widowers. Br Med J. 1969 Mar 22;1(5646):740–743. doi: 10.1136/bmj.1.5646.740. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Peto R., Pike M. C., Armitage P., Breslow N. E., Cox D. R., Howard S. V., Mantel N., McPherson K., Peto J., Smith P. G. Design and analysis of randomized clinical trials requiring prolonged observation of each patient. II. analysis and examples. Br J Cancer. 1977 Jan;35(1):1–39. doi: 10.1038/bjc.1977.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Ramirez A. J., Craig T. K., Watson J. P., Fentiman I. S., North W. R., Rubens R. D. Stress and relapse of breast cancer. BMJ. 1989 Feb 4;298(6669):291–293. doi: 10.1136/bmj.298.6669.291. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Rees W. D., Lutkins S. G. Mortality of bereavement. Br Med J. 1967 Oct 7;4(5570):13–16. doi: 10.1136/bmj.4.5570.13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Seeman T. E., Kaplan G. A., Knudsen L., Cohen R., Guralnik J. Social network ties and mortality among the elderly in the Alameda County Study. Am J Epidemiol. 1987 Oct;126(4):714–723. doi: 10.1093/oxfordjournals.aje.a114711. [DOI] [PubMed] [Google Scholar]
  32. Susser M. Widowhood: a situational life stress or a stressful life event? Am J Public Health. 1981 Aug;71(8):793–795. doi: 10.2105/ajph.71.8.793. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Tretli S., Haldorsen T., Ottestad L. The effect of pre-morbid height and weight on the survival of breast cancer patients. Br J Cancer. 1990 Aug;62(2):299–303. doi: 10.1038/bjc.1990.282. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Ward A. W. Mortality of bereavement. Br Med J. 1976 Mar 20;1(6011):700–702. doi: 10.1136/bmj.1.6011.700. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. YOUNG M., BENJAMIN B., WALLIS C. THE MORTALITY OF WIDOWERS. Lancet. 1963 Aug 31;2(7305):454–456. doi: 10.1016/s0140-6736(63)92193-7. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES