Hostname: page-component-5d59c44645-mhl4m Total loading time: 0 Render date: 2024-02-21T10:28:58.864Z Has data issue: false hasContentIssue false

Divorce after breast cancer diagnosis and its impact on quality of life

Published online by Cambridge University Press:  15 November 2021

Danbee Kang
Affiliation:
Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
Nayeon Kim
Affiliation:
Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Gayeon Han
Affiliation:
Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
Sooyeon Kim
Affiliation:
Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
Hoyoung Kim
Affiliation:
Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Jihyun Lim
Affiliation:
Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
Hyunsoo Kim
Affiliation:
Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
Sungkeun Shim
Affiliation:
Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea
Mangyeong Lee
Affiliation:
Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea
Jeong Eon Lee
Affiliation:
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Seok Jin Nam
Affiliation:
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Seok Won Kim
Affiliation:
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
Jonghan Yu
Affiliation:
Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea
Se Kyung Lee
Affiliation:
Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea
Juhee Cho*
Affiliation:
Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
*
Author for correspondence: Juhee Cho, Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, 115 Irwon-ro, Gangnam, Seoul 06335, South Korea. E-mail: jcho@skku.edu

Abstract

Objective

This study aims to identify factors associated with divorce following breast cancer diagnosis and measures the impact of divorce on the quality of life (QoL) of patients.

Methods

We used cross-sectional survey data collected at breast cancer outpatient clinics in South Korea from November 2018 to April 2019. Adult breast cancer survivors who completed active treatment without any cancer recurrence at the time of the survey (N = 4,366) were included. The participants were classified into two groups: “maintaining marriage” and “being divorced,” between at the survey and at the cancer diagnosis. We performed logistic regression and linear regression to identify the factors associated with divorce after cancer diagnosis and to compare the QoL of divorced and nondivorced survivors.

Results

Approximately 11.1/1,000 of married breast cancer survivors experienced divorce after cancer diagnosis. Younger age, lower education, and being employed at diagnosis were associated with divorce. Being divorced survivors had significantly lower QoL (Coefficient [Coef] = −7.50; 95% CI = −13.63, −1.36), social functioning (Coef = −9.47; 95% CI = −16.36, −2.57), and body image (Coef = −8.34; 95% CI = −6.29, −0.39) than survivors who remained married. They also experienced more symptoms including pain, insomnia, financial difficulties, and distress due to hair loss.

Conclusion

Identifying risk factors of divorce will ultimately help ascertain the resources necessary for early intervention.

Type
Original Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abdollah, F, Sun, M, Thuret, R, et al. (2011) The effect of marital status on stage and survival of prostate cancer patients treated with radical prostatectomy: A population-based study. Cancer Causes & Control 22(8), 10851095.CrossRefGoogle ScholarPubMed
Aizer, AA, Chen, MH, McCarthy, EP, et al. (2013) Marital status and survival in patients with cancer. Journal of Clinical Oncology 31(31), 38693876.CrossRefGoogle ScholarPubMed
Ayanian, JZ and Jacobsen, PB (2006) Enhancing research on cancer survivors. Journal of Clinical Oncology 24(32), 51495153.CrossRefGoogle ScholarPubMed
Boswell, EN and Dizon, DS (2015) Breast cancer and sexual function. Translational Andrology and Urology 4(2), 160168.Google ScholarPubMed
Breslau, J, Miller, E, Jin, R, et al. (2011) A multinational study of mental disorders, marriage, and divorce. Acta Psychiatrica Scandinavica 124(6), 474486.CrossRefGoogle ScholarPubMed
Broderick, CB (1993) Understanding Family Process: Basics of Family Systems Theory. Thousand Oaks, CA: Sage Publications.Google Scholar
Carlsen, K, Dalton, SO, Frederiksen, K, et al. (2007) Are cancer survivors at an increased risk for divorce? A Danish cohort study. European Journal of Cancer 43(14), 20932099.CrossRefGoogle ScholarPubMed
Chang, SM and Barker, FG 2nd (2005) Marital status, treatment, and survival in patients with glioblastoma multiforme: A population based study. Cancer 104(9), 19751984.CrossRefGoogle ScholarPubMed
Chen, DN, Song, CG, Ouyang, QW, et al. (2015) Differences in breast cancer characteristics and outcomes between Caucasian and Chinese women in the US. Oncotarget 6(14), 1277412782.CrossRefGoogle ScholarPubMed
Cheng, Y-h (2016) More education, fewer divorces? Shifting education differentials of divorce in Taiwan from 1975 to 2010. Demographic Research 34, 927942.CrossRefGoogle Scholar
Christoffersen, MN (2002) Dissolved families: A prospective longitudinal cohort study of family strain before parental separation following schoolchildren born in Denmark 1973. In: Carling J (ed.) Nordic demography: Trends and differentials. Scandinavian Population Studies 13, 231–250. [Oslo: Unipub/Nordic Demographic Society].Google Scholar
Ding, W, Ruan, G, Lin, Y, et al. (2021) Dynamic changes in marital status and survival in women with breast cancer: A population-based study. Scientific Reports 11(1), 5421.CrossRefGoogle ScholarPubMed
Dorval, M, Maunsell, E, Taylor-Brown, J, et al. (1999) Marital stability after breast cancer. Journal of the National Cancer Institute 91(1), 5459.CrossRefGoogle ScholarPubMed
Dorval, M, Guay, S, Mondor, M, et al. (2005) Couples who get closer after breast cancer: Frequency and predictors in a prospective investigation. Journal of Clinical Oncology 23(15), 35883596.CrossRefGoogle Scholar
Fayers, PM, Aaronson, NK, Bjordal, K, et al. (2001) The EORTC QLQ-C30 Scoring Manual. Brussels, Belgium: European Organization for Research and Treatment of Cancer.Google Scholar
Hinnen, C, Hagedoorn, M, Ranchor, AV, et al. (2008) Relationship satisfaction in women: A longitudinal case-control study about the role of breast cancer, personal assertiveness, and partners’ relationship-focused coping. British Journal of Health Psychology 13(Pt 4), 737754.CrossRefGoogle ScholarPubMed
Jones, GW (2012) Changing family sizes, structures and functions in Asia. Asia-Pacific Population Journal 27(1), 83102.CrossRefGoogle Scholar
Kang, SY, Kim, YS, Kim, Z, et al. (2020) Breast cancer statistics in Korea in 2017: Data from a breast cancer registry. Journal of Breast Cancer 23(2), 115128.CrossRefGoogle ScholarPubMed
Kirchhoff, AC, Yi, J, Wright, J, et al. (2012) Marriage and divorce among young adult cancer survivors. Journal of Cancer Survivorship: Research and Practice 6(4), 441450.CrossRefGoogle ScholarPubMed
Kornblith, AB, Herndon, JE 2nd, Zuckerman, E, et al. (2001) Social support as a buffer to the psychological impact of stressful life events in women with breast cancer. Cancer 91(2), 443454.3.0.CO;2-Z>CrossRefGoogle Scholar
Lee, Y-J (2006) Risk factors in the rapidly rising incidence of divorce in Korea. Asian Population Studies 2(2), 113131.CrossRefGoogle Scholar
Lehto, US, Ojanen, M and Kellokumpu-Lehtinen, P (2005) Predictors of quality of life in newly diagnosed melanoma and breast cancer patients. Annals of Oncology 16(5), 805816.CrossRefGoogle ScholarPubMed
Li, Q, Gan, L, Liang, L, et al. (2015) The influence of marital status on stage at diagnosis and survival of patients with colorectal cancer. Oncotarget 6(9), 73397347.CrossRefGoogle ScholarPubMed
Mammen, K and Paxson, C (2000) Women's work and economic development. The Journal of Economic Perspectives 14(4), 141164.CrossRefGoogle Scholar
Manne, S and Badr, H (2008) Intimacy and relationship processes in couples’ psychosocial adaptation to cancer. Cancer 112(11 Suppl), 25412555.CrossRefGoogle ScholarPubMed
Meltzer, AL and McNulty, JK (2010) Body image and marital satisfaction: Evidence for the mediating role of sexual frequency and sexual satisfaction. Journal of Family Psychology 24(2), 156164.CrossRefGoogle ScholarPubMed
Poortman, A-R (2005) Women's work and divorce: A matter of anticipation? A research note. European Sociological Review 21(3), 301309.CrossRefGoogle Scholar
Poortman, A-R and Kalmijn, M (2002) Women's labour market position and divorce in the Netherlands: Evaluating economic interpretations of the work effect. European Journal of Population/Revue européenne de Démographie 18(2), 175202.CrossRefGoogle Scholar
Qiu, M, Yang, D and Xu, R (2016) Impact of marital status on survival of gastric adenocarcinoma patients: Results from the Surveillance Epidemiology and End Results (SEER) database. Scientific Reports 6, 21098.CrossRefGoogle ScholarPubMed
Reyes Ortiz, CA, Freeman, JL, Kuo, YF, et al. (2007) The influence of marital status on stage at diagnosis and survival of older persons with melanoma. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 62(8), 892898.CrossRefGoogle ScholarPubMed
Socialstyrelsen (2006) Social Rapport 2001. Stockholm: Socialstyrelsen. pp. 140141.Google Scholar
Syse, A, Loge, JH and Lyngstad, TH (2010) Does childhood cancer affect parental divorce rates? A population-based study. Journal of Clinical Oncology 28(5), 872877.CrossRefGoogle ScholarPubMed
Wu, TY, Chang, TW, Chang, SM, et al. (2019) Dynamic changes of body image and quality of life in breast cancer patients. Cancer Management and Research 11, 1056310571.CrossRefGoogle ScholarPubMed
Yildiz, F and Alagüney, M (2020) Is early-stage breast cancer a risk for marital-dissolution? Medical Science and Discovery 7, 566569.CrossRefGoogle Scholar
Yun, YH, Bae, SH, Kang, IO, et al. (2004) Cross-cultural application of the Korean version of the European Organization for Research and Treatment of Cancer (EORTC) Breast-Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Supportive Care in Cancer 12(6), 441445.Google Scholar
Zhai, Z, Zhang, F, Zheng, Y, et al. (2019) Effects of marital status on breast cancer survival by age, race, and hormone receptor status: A population-based study. Cancer Medicine 8(10), 49064917.CrossRefGoogle ScholarPubMed