Buja A, Lago L, Lago S, Vinelli A, Zanardo C, Baldo V
Dept. of Cardiologic, Vascular, Thoracic Sciences and Public Health, Laboratory of Health Care Services and Health Promotion Evaluation, Unit of Hygiene and Public Health, University of Padova, Padova, Italy.
Master course in Sciences of the Public Health and Prevention Professions, University of Padova, Padova, Italy.
Eur J Cancer Care (Engl). 2018 Jan;27(1). doi: 10.1111/ecc.12755. Epub 2017 Aug 29.
Early cancer detection is fundamental to the promotion of better health in the community, but disparities remain in the likelihood of cancer being detected at an early stage, some of which relate to socio-demographic factors such as marital status. The aim of this study was to conduct a systematic review of research on the association between marital status and stage at diagnosis of different types of cancer. A comprehensive systematic literature search was run in the Medline and Scopus databases (from January 1990 to June 2014), identifying 245 and 208 articles on PubMed and Scopus respectively. Of these 453 studies, 18 were judged eligible for this systematic review. A quality assessment was performed on the studies using the 22 items in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist. This review confirmed the important influence of being married on the earlier detection of cancer. None of the studies considered identified more cases of cancer in a later stage among married patients, and the majority of them reported a statically significant association between marital status and stage at diagnosis, with a positive effect of marriage on the likelihood of cancer being diagnosed at an early stage, for various types of malignancy. In particular, our meta-analysis showed that the unmarried have higher odds of having a later stage of breast cancer (OR = 1.287 95% CI: 1.025-1.617) or melanoma (OR = 1.350 95% CI: 1.161-1.570) at diagnosis. Specific interventions should be developed for the unmarried population to improve their chances of any neoplasms being diagnosed at an early stage, thereby reducing health disparities in the population at large.
早期癌症检测对于促进社区居民的健康至关重要，但在癌症早期检测的可能性方面仍然存在差异，其中一些差异与社会人口因素如婚姻状况有关。本研究的目的是对婚姻状况与不同类型癌症诊断阶段之间关联的研究进行系统综述。在Medline和Scopus数据库（1990年1月至2014年6月）中进行了全面的系统文献检索，分别在PubMed和Scopus上确定了245篇和208篇文章。在这453项研究中，有18项被判定符合本系统综述的要求。使用STROBE（加强流行病学观察性研究报告）清单中的22项对这些研究进行了质量评估。本综述证实了已婚对癌症早期检测的重要影响。所纳入的研究均未发现已婚患者中晚期癌症病例更多，并且其中大多数报告婚姻状况与诊断阶段之间存在统计学上的显著关联，对于各种类型的恶性肿瘤，婚姻对癌症早期诊断的可能性有积极影响。特别是，我们的荟萃分析表明，未婚者在诊断时患晚期乳腺癌（OR = 1.287，95%CI：1.025 - 1.617）或黑色素瘤（OR = 1.350，95%CI：1.161 - 1.570）的几率更高。应为未婚人群制定具体干预措施，以提高他们早期诊断任何肿瘤的机会，从而减少整个人口中的健康差距。
