Marital status and prostate cancer incidence: a pooled analysis of 12 case-control studies from the PRACTICAL consortium

Salmon C 1 , Song L 2 , Muir K 3 , UKGPCS Collaborators , Pashayan N 4 , Dunning AM 5 Show all authors , Batra J 6 , APCB BioResource (Australian Prostate Cancer BioResource) , Chambers S 7 , Stanford JL 8 , Ostrander EA 9 , Park JY 10 , Lin HY 11 , Cussenot O 12 , Cancel-Tassin G 12 , Menegaux F 13 , Cordina-Duverger E 13 , Kogevinas M 14 , Llorca J 15 , Kaneva R 16 , Slavov C 17 , Razack A 18 , Lim J 18 , Gago-Dominguez M 19 , Castelao JE 20 , Kote-Jarai Z 21 , Eeles RA 21 , on behalf of the PRACTICAL Consortium , Parent MÉ 22

Affiliations 

  • 1 Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, University of Quebec, 531 boul. des Prairies, Laval, QC, H7V 1B7, Canada
  • 2 Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
  • 3 Division of Population Health, Health Services Research and Primary Care, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
  • 4 Department of Applied Health Research, University College London, London, WC1E 7HB, UK
  • 5 Strangeways Laboratory, Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Worts Causeway, Cambridge, CB1 8RN, UK
  • 6 Australian Prostate Cancer Research Centre-Qld, Institute of Health and Biomedical Innovation and School of Biomedical Sciences, Queensland University of Technology, Brisbane, QLD, 4059, Australia
  • 7 Faculty of Health Sciences, Australian Catholic University, Sydney, Australia
  • 8 Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, 98109-1024, USA
  • 9 National Human Genome Research Institute, National Institutes of Health, 50 South Drive, Rm. 5351, Bethesda, MD, 20892, USA
  • 10 Department of Cancer Epidemiology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA
  • 11 School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
  • 12 Sorbonne Université, GRC n°5, AP-HP, Tenon Hospital, 4 rue de la Chine, 75020, Paris, France
  • 13 Exposome and Heredity Team, CESP, UVSQ, INSERM, Gustave Roussy, Paris-Saclay University, 94805, Villejuif, France
  • 14 ISGlobal, Barcelona, Spain
  • 15 CIBER Epidemiología Y Salud Pública (CIBERESP), 28029, Madrid, Spain
  • 16 Molecular Medicine Center, Department of Medical Chemistry and Biochemistry, Medical University of Sofia, Sofia, 2 Zdrave Str., 1431, Sofia, Bulgaria
  • 17 Department of Urology and Alexandrovska University Hospital, Medical University of Sofia, 1431, Sofia, Bulgaria
  • 18 Department of Surgery, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
  • 19 Genomic Medicine Group, Galician Foundation of Genomic Medicine, Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Complejo Hospitalario Universitario de Santiago, Servicio Galego de Saúde, SERGAS, 15706, Santiago de Compostela, Spain
  • 20 Genetic Oncology Unit, CHUVI Hospital, Complexo Hospitalario Universitario de Vigo, Instituto de Investigación Biomédica Galicia Sur (IISGS), 36204, Vigo (Pontevedra), Spain
  • 21 The Institute of Cancer Research, London, SM2 5NG, UK
  • 22 Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, University of Quebec, 531 boul. des Prairies, Laval, QC, H7V 1B7, Canada. [email protected]
Eur J Epidemiol, 2021 Sep;36(9):913-925.
PMID: 34275018 DOI: 10.1007/s10654-021-00781-1

Abstract

While being in a committed relationship is associated with a better prostate cancer prognosis, little is known about how marital status relates to its incidence. Social support provided by marriage/relationship could promote a healthy lifestyle and an increased healthcare seeking behavior. We investigated the association between marital status and prostate cancer risk using data from the PRACTICAL Consortium. Pooled analyses were conducted combining 12 case-control studies based on histologically-confirmed incident prostate cancers and controls with information on marital status prior to diagnosis/interview. Marital status was categorized as married/partner, separated/divorced, single, or widowed. Tumours with Gleason scores ≥ 8 defined high-grade cancers, and low-grade otherwise. NCI-SEER's summary stages (local, regional, distant) indicated the extent of the cancer. Logistic regression was used to derive odds ratios (ORs) and 95% confidence intervals (CI) for the association between marital status and prostate cancer risk, adjusting for potential confounders. Overall, 14,760 cases and 12,019 controls contributed to analyses. Compared to men who were married/with a partner, widowed men had an OR of 1.19 (95% CI 1.03-1.35) of prostate cancer, with little difference between low- and high-grade tumours. Risk estimates among widowers were 1.14 (95% CI 0.97-1.34) for local, 1.53 (95% CI 1.22-1.92) for regional, and 1.56 (95% CI 1.05-2.32) for distant stage tumours. Single men had elevated risks of high-grade cancers. Our findings highlight elevated risks of incident prostate cancer among widowers, more often characterized by tumours that had spread beyond the prostate at the time of diagnosis. Social support interventions and closer medical follow-up in this sub-population are warranted.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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