Should’ve put a ring on it? Maybe! Marriage is linked to lower risk of cancer
By Michal Ruprecht, CNN
(CNN) — Marriage has existed for thousands of years – and it was once “almost universal,” according to Dr. Andrew J. Cherlin. But marriage rates are falling, and that means some people may be missing out on a potential health benefit.
“It’s almost as if we split into two different societies,” said Cherlin, a professor emeritus at Johns Hopkins University, who studies the sociology of families – pointing to the advantages marriage can confer.
A study published Wednesday in the journal Cancer Research Communications suggests that matrimony may be linked to a lower risk of cancer, adding to a growing body of research tying it to improved health outcomes.
Among never-married men, cancer rates are 68% higher than those who have been married, a group that includes those who have been divorced or widowed. The incidence is even higher – 83% – for women who have never married.
“When it comes to getting cancer, putting a ring on it may offer more protection to women,” said Dr. Brad Wilcox, a professor at the University of Virginia who studies marriage. Wilcox, who was not involved with the new research, added, “That’s striking.”
Research on marriage generally suggests that men stand to benefit more than women in heterosexual relationships. This study suggests the opposite.
The study authors say the finding probably has multiple causes. For some cancers, such as endometrial and ovarian cancers, the trend might be related to reproductive mechanisms. Women who have never given birth are at a higher risk of those cancers.
For older adults in the new observational study, the correlation strengthened, suggesting that the effect of marriage “accumulates” over time, said Dr. Paulo S. Pinheiro, the lead author of the study and an epidemiologist at the University of Miami Health System.
When the data was broken down by race and ethnicity, Black men appeared to benefit most from marriage. Dr. Jarrod A. Carrol, a geriatrician who sees patients at Kaiser Permanente in Southern California, said the finding speaks to the “power of the Black woman.”
“They provide support and they encourage a Black man to seek earlier treatment and evaluation,” said Carrol, who wasn’t involved in the new research. “As a result of the Black woman being like the hub of support for the entire family, I think it speaks to how they are intrinsically invested in the care of their spouse.”
Why does marriage come with benefits?
Although the concept of marriage is constantly in flux, Cherlin said, one core question has endured: Does marriage make people healthier, or are healthier people the ones who get married?
Marriage typically confers advantages such as access to health care and social support. The study authors also argue that people who have been married are less likely to partake in risky behavior, pointing to data showing that marriage was strongly linked to lower rates of lung and cervical cancer. These cancers are related to risky behaviors like promiscuity, smoking and drinking.
Additionally, “If you’re unmarried and more isolated, you’re less likely to … engage in screening or prevention,” Pinheiro said.
However, Dr. Joan DelFattore, who has spent the past decade writing about cancer and marital status in academic journals and mass media, argues that the benefits of marriage often reflect systems that reward it rather than marriage itself. For instance, many health insurance plans extend coverage to spouses but exclude others.
DelFattore, who was not involved with the new study, said policies like these contribute to a false idea that marriage itself is what drives better outcomes.
“People start from the assumption ‘Marriage: good. No marriage: bad’ and interpret things in ways that do not make sense in terms of actual data,” she said. That bias, which she says is embedded in research and medical training, often leads to conclusions that are “highly oversimplified.”
Single with cancer
DelFattore was diagnosed with stage IV gallbladder cancer 15 years ago. During a visit with her oncologist, DelFattore – who is unmarried – said she wasn’t offered the same level of care a married person would have received.
The oncologist “was absolutely immovably convinced that as a single woman … I could not possibly have the social support to handle aggressive treatment,” said DelFattore, who chronicled her story in The New England Journal of Medicine. But she says the doctor’s assumption was misguided.
“I tried to tell him about the cousins and the friends who provide me with a very strong support system. He actually interrupted me. I couldn’t even finish the sentence.”
Research shows that single people going through cancer care have worse outcomes, and DelFattore said those disparities are amplified by stereotypes often held by doctors.
“There is this assumption that there is a stark dichotomy between being married and being on your own,” she said.
Moving forward, Pinheiro said, more research should be done on ways to support unmarried people. DelFattore added that the focus shouldn’t be on just encouraging more people to get married but rather on removing barriers that leave unmarried patients at a disadvantage.
Pinheiro said it’s also an opportunity for doctors to spend more time counseling patients who lack built-in support at home. Those who choose to remain single should build strong support networks, he said.
These networks are strongest if people step in to provide accountability, check in periodically and help navigate care when needed. DelFattore added that these relationships can be just as strong as marital ones.
“The neighbor might very well help you into the shower,” DelFattore said. “There’s much more intimate care … not limited to only a spouse. Non-marital support can be just as extremely effective.”
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