The effect of marital status on cervical cancer related prognosis: a propensity score matching study

Cervical cancer is the fourth most common malignancy in women worldwide and the fourth leading cause of cancer death in women. Although an association between marital status and prognosis has been observed in a variety of malignancies, this link has not been fully elucidated in the field of cervical cancer. A total of 30,853 patients were enrolled in this study, of whom 14,286 (46.3%) were married and 16,567 (53.7%) were unmarried. The median follow-up time was 76 months. Before propensity score matching (PSM), cancer-specific survival (CSS) (HR = 1.55, 95% CI 1.49-1.61, p < 0.001) and overall survival (OS) (HR = 1.66, 95% CI 1.61-1.73, p < 0.001) in unmarried patients were significantly lower than those in married patients. After 1:1 PSM matching, there were 10,771 patients in each of the two groups, and baseline features were balanced (p > 0.05 for all variables). Even after PSM, CSS (HR = 1.07, 95% CI 1.02-1.13, p = 0.003) and OS (HR = 1.13, 95% CI 1.08-1.18, p < 0.001) of unmarried patients were significantly lower than those of married patients. Multivariate Cox regression analysis confirmed that unmarried status was an independent risk factor for CSS (HR = 1.12, 95% CI 1.07-1.17, p < 0.001) and OS (HR = 1.19, 95% CI 1.14-1.24, p < 0.001). Based on the large sample size analysis, this study revealed the association between unmarried status and poor prognosis of cervical cancer, and confirmed that marital status is an independent factor affecting the prognosis of cervical cancer. Nevertheless, more prospective studies and in-depth mechanistic studies are needed to validate our findings and explore the biological basis behind them.