Elovainio Marko, Lumme Sonja, Arffman Martti, Manderbacka Kristiina, Pukkala Eero, Hakulinen Christian
Research Program Unit, Faculty of Medicine, University of Helsinki, Finland.
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland.
SSM Popul Health. 2021 Jun 11;15:100826. doi: 10.1016/j.ssmph.2021.100826. eCollection 2021 Sep.
Lack of social contacts has been associated with an increased risk of cancer mortality, but it is not known whether living alone increases the risk of cancer incidence or case fatality. We examined the association between living alone with cancer incidence, case-fatality and all-cause mortality in eight most common cancers. All patients with their first cancer diagnosis in 2000-2017 were identified from the nationwide Finnish Cancer Registry. Information on living arrangements was derived from Statistics Finland. The incidence analyses were conducted using Poisson regression. The total Finnish population served as the population at risk. Fine-Gray model was used to estimate case-fatality and Cox proportional regression model all-cause mortality. In men, we found an association between history of living alone and excess lung cancer incidence but living alone seemed to be associated with lower incidence of prostate cancer and skin melanoma. In women, living alone was more consistently associated with higher incidence of all studied cancers. Cancer patients living alone had an 11%-80% statistically significantly increased case-fatality and all-cause mortality in all studied cancers in men and in breast, colorectal and lung cancer in women. Living alone is consistently associated with increased cancer incidence risk in women but only in some cancers in men. Both men and women living alone had an increased risk of all-cause mortality after cancer diagnosis.
缺乏社交联系与癌症死亡率增加有关，但独居是否会增加癌症发病率或病死率尚不清楚。我们研究了独居与八种最常见癌症的发病率、病死率和全因死亡率之间的关联。从芬兰全国癌症登记处识别出所有在2000年至2017年首次诊断为癌症的患者。居住安排信息来自芬兰统计局。发病率分析采用泊松回归进行。芬兰总人口作为风险人群。采用Fine-Gray模型估计病死率，采用Cox比例回归模型估计全因死亡率。在男性中，我们发现独居史与肺癌发病率增加有关，但独居似乎与前列腺癌和皮肤黑色素瘤发病率较低有关。在女性中，独居与所有研究癌症的较高发病率更一致地相关。独居的癌症患者在所有研究的男性癌症以及女性乳腺癌、结直肠癌和肺癌中，病死率和全因死亡率在统计学上显著增加11% - 80%。独居与女性癌症发病率风险增加始终相关，但仅与男性的某些癌症有关。独居的男性和女性在癌症诊断后全因死亡风险均增加。
