TABLE 3.
Relative Hazards of Mortality by Level of Social Integration Among Women in the Women’s Health Initiative Diagnosed With Colorectal Cancer, N = 1143
| Characteristic | Level of Social Integrationa |
Pb | ||
|---|---|---|---|---|
| Socially Integrated | Moderately Integrated | Socially Isolated | ||
| No. of women | 273 | 494 | 374 | |
| Overall mortality, no. | 96 | 203 | 170 | |
| Model 1: HR (95% CI)c | 1.00 | 1.20 (0.94–1.54) | 1.36 (1.05–1.76) | .007 |
| Model 2: HR (95% CI)d | 1.00 | 1.18 (0.92–1.52) | 1.32 (1.01–1.71) | .02 |
| Model 3: HR (95% CI)e | 1.00 | 1.14 (0.89–1.48) | 1.27 (0.97–1.66) | .03 |
| CRC-specific mortality, no. | 59 | 135 | 98 | |
| Model 1: HR (95% CI)c | 1.00 | 1.16 (0.86–1.58) | 1.22 (0.88–1.68) | .18 |
| Model 2: HR (95% CI)d | 1.00 | 1.20 (0.88–1.64) | 1.21 (0.87–1.69) | .25 |
| Model 3: HR (95% CI)e | 1.00 | 1.07 (0.78–1.46) | 1.14 (0.81–1.61) | .33 |
Abbreviations: CRC, colorectal cancer; HR, hazard ratio.
Levels of social integration are indicated in approximate tertiles (for a description of the measure for social integration, see Social integration [social network size] and social ties).
P values were used from continuous measures of social integration.
Model 1 was a minimally adjusted model adjusted for age at diagnosis (continuous), time between social assessment and diagnosis (continuous), study (clinical trial, observational study), race/ethnicity (non-Hispanic white [reference category], African-American, Asian/Pacific Islander, Hispanic, other), and stage and grade (local [reference category], regional, distant and well differentiated/moderately differentiated, distant and nondifferentiated/anaplastic).
Model 2, which included possible confounding variables, was adjusted for the covariates in model 1 and additionally for site (rectal, colon [reference category]), education (<high school, high school, some college, college degree or greater [reference category]), income (<$20,000, $20,000 to <$50,000, ≥$50,000 [reference category]), family history of colorectal cancer (yes, no [reference category]), and comorbidity (yes, no [reference category]).
Model 3, which considered mediation by depressive symptoms and treatment and lifestyle factors, was adjusted for the covariates in model 2 and was also adjusted for surgery (yes, no [reference category]), chemotherapy (yes, no [reference category]), radiation (yes, no [reference category]), colorectal cancer screening (yes, no [reference category]), depressive symptomatology (continuous), aspirin or ibuprofen use (yes, no [reference category]), use of hormone therapy (yes, no [reference category]), alcohol intake (none [reference category], >0 to <1.7, 1.7 to <15, ≥15 g/day), smoking (never [reference category], past, current), physical activity (0 to <10 [reference category], 10 to <20, ≥20+ metabolic equivalents per week), and body mass index (<18.5, 18.5–25 [reference category]), 25-<30, ≥30 kg/m2).