Impacts of Demographic and Social Support on Cancer Severity: SEER Data 1973-2010

Background: Research has demonstrated health disparities in cancer prevalence and outcomes. Research also indicates the importance of social supports for enhancing cancer outcomes, consistent with biopsychosocial models. Furthermore, Healthy People 2020 objectives include measures for improved quality of life and longevity for persons with cancer.

Purpose: We evaluated cancer outcomes based upon race, gender, and marital status in the National Cancer Institute SEER cancer registry, 1973-2010.

Significance:  Evaluation of the impact on cancer outcomes for social supports, including marital status, across race and other demographics may be useful for public health interventions to improve cancer survival and positive outcomes.

Methodology: We used MANOVA to test the associations between the independent variables race, gender, and marital status on age at diagnosis, number of benign/malignant tumors, behavior code, and differentiation grade for n = 65,535 persons in the SEER leukemia registry for years 1973-2010. Individual cases were omitted if there was missing data or if age < 18 years. We also examined temporal geospatial patterns for outcomes from 1973-2010.

Conclusions: There were significant (p < .001) differences in age at diagnosis, behavior code, and grade based upon race, gender, and marital status. Whereas the sample was representative and disproportionately Caucasian, African Americans showed more negative outcomes. The study was further limited by lack of genetic data. The results indicate racial disparities in leukemia outcomes and potential positive benefits of marriage and/or social support mechanisms, consistent with research, biopsychosocial models, and suggesting public health interventions to promote improved outcomes for persons with cancer.