Gender Differences in Marital Disruption among Patients with Cancer: Results from the Korean National Health and Nutrition Examination Survey (KNHANES)

  • Song, Hai-Yan (Department of Public Health, Graduate School, Yonsei University College of Medicine) ;
  • Kwon, Jeoung-A (Department of Public Health, Graduate School, Yonsei University College of Medicine) ;
  • Choi, Jae-Woo (Department of Public Health, Graduate School, Yonsei University College of Medicine) ;
  • Kim, Sun-Jung (Department of Public Health, Graduate School, Yonsei University College of Medicine) ;
  • Park, Eun-Cheol (Institute of Health Services Research, Yonsei University College of Medicine)
  • Published : 2014.08.30


Background: Cancer is a major life event that imposes huge economic and mental burdens on patients and families. In addition, the diagnosis of cancer also causes significant family discordance that can lead to marital problems such as divorce or separation. The aim of this study was to investigate the association and any related gender differences between cancer diagnosis and marital disruption among cancer survivors. Materials and Methods: We used the recent cross-sectional Korea National Health and Nutrition Examination Survey ($4^{th}$ and $5^{th}$; Years 2008-2012). The study participants were 623 married cancer survivors over the age of 19. A multivariate logistic regression analysis was conducted to estimate odds ratios. Results: After adjusting for socioeconomic status and health-related behaviors, the odds ratio of marital disruption among female cancer survivors compared with male cancer survivors was 3.94 (95%CI 1.30-11.94; p=0.02). The odds ratio of marital disruption for the below-average economic level compared with the above-average economic level was 5.64 (95%CI: 1.03-31.02; p=0.05). When compared with the non-smoking cancer survivors, the smoking cancer survivors had an OR of marital disruption equal to 2.94 (95%CI: 1.08-8.00; p=0.03). Conclusions: The findings of this study suggest that the odds of marital disruption among female cancer survivors are higher than those among their male couterparts. Medical practitioners should be sensitive to early signs of marital discord in couples affected by a cancer diagnosis. Early identification and psychosocial intervention might reduce the frequency of divorce and separation and thus improve quality of life and quality of care for cancer survivors.


marital disruption;female;divorces;separation;cancer survivor


  1. Bernardi F, Juan-Ignacio, Martinez-Pastor (2011). Divorce risk factors and their variation over time in Spain. Demographic Research, 24.
  2. Carlsen K, Dalton SO, Frederiksen K, et al (2007). Are cancer survivors at an increased risk for divorce? A Danish cohort study. Eur J Cancer, 43, 2093-9.
  3. Christoffersen M (2002). Dissolved families.
  4. Cull A, Cowie V, Farquharson D, et al (1993). Early stage cervical cancer: psychosocial and sexual outcomes of treatment. Br J Cancer, 86, 1216-20.
  5. Doyle C, Kushi L, Byers T, et al (2006). Nutrition and physical activity during and agter cancer treatment: an American Cancer Society guide for informed choices. CA Cancer J Clin, 56, 323-53.
  6. Esping-Andersen G (2009). The Incomplete revolution: adapting welfare states to women's new roles. Cambridge, UK: Polity Press.
  7. Ezat WP, Noraziani K, Sabrizan O (2012). Improving quality of life among cancer patients in Malaysia. Asian Pac J Cancer Prev, 13, 1069-75.
  8. Glantz MJ, Chamberlain MC, Liu Q, et al (2009). Gender disparity in the rate of partner abandonment in patients with serious medical illness. Cancer, 115, 5237-42.
  9. Gurney J, Krull K, Kadan-Lottick N, et al (2009). Social outcomes in the childhood cancer survivor study cohort. J Clin Oncol, 27, 2390-5.
  10. Hassali MA, Knight A, Shafie AA, et al (2013). Cross sectional assessment of health related quality of life (HRQoL) among patients with cancer in Malaysia. Asian Pac J Cancer Prev, 14, 3017-21.
  11. Ahmad Kiadaliri A, Bastani P, Ibrahimipour H (2012). Healthrelated quality of life of breast cancer patients in Iran: pooled analysis using generalized estimating equations. Asian Pac J Cancer Prev, 13, 941-4.
  12. Avci IA, Kumcagiz H (2011). Marital adjustment and loneliness status of women with mastectomy and husbands reactions. Asian Pac J Cancer Prev, 12, 453-9.
  13. Hawighorst-Knapstein S, Fusshoeller C, Franz C, et al (2004). The impact of treatment for genital cancer on quality of life and body image- results of a prospective longitudinal 10-year study. Gynecol Oncol, 94, 398-403.
  14. Johansen C, Schou G, Soll-Johanning H, et al (1996). Influence of marital status on survival from colon and rectal cancer in Denmark. Br J Cancer, 74, 985-8.
  15. Jolovaara, Marika (2003). The joint effects of marriage partners' socioeconomic positions on the risk of divorce. Demography, 40, 67-81.
  16. Juraskova I, Butow P, Robertson R, et al (2003). Post-treatment sexual adjustment following cervical and endometrial cancer: a qualitative insight. Psychooncology, 12, 267-79.
  17. Kato I, Tominaga S, Ikari A (1992). The role of socioeconomic factors in the survival of patients with gastrointestinal cancers. Jpn J Chin Oncol, 22, 270-7.
  18. Kirchhoff AC, Yi J, Wright J, et al (2012). Marriage and divorce among young adult cancer survivors. J Cancer Survive, 6, 441-50.
  19. Kvikstad A, Vatten L, Tretli S (1995). Widowhood and divorce in relation to overall survival among middle-aged Norwegian women with cancer. Br J Cancer, 71, 1343-7.
  20. Lee S, Cho E, Grodsein F, et al (2005). Effects of marital transitions on change in dietary and other health behaviours in US women. Int J Epidemiol, 34, 69-78.
  21. Majeed W, Aslam B, Javed I, et al (2014). Breast cancer: major risk factors and recent developments in treatment. Asian Pac J Cancer Prev, 15, 3353-8.
  22. Mohammadi S, Sulaiman S, Koon PB, et al (2013). Association of nutritional status with quality of life in breast cancer survivors. Asian Pac J Cancer Prev, 14, 7749-55.
  23. Nazik E, Ozdemir F, Soydan S (2014). Social support and quality of life in Turkish patients with gynecologic cancer. Asian Pac J Cancer Prev, 15, 3081-6.
  24. Northouse L, Kershaw T, Mood D, Schafenacher A (2005). Effects of a family intervention on the quality of life of women with recurrent breast cancer and their family caregivers. Psychooncology, 22, 270-7.
  25. Oppenheimer, Valerie K (1997). Women's employment and the gain to marriage: the specialization and trading model. Annual Review of Sociology, 23, 431-53.
  26. Ozturk C, Bektas M, Mert O (2014). Effects of cigarette smoking across three generations and of perceptions of the smokingcancer relationship on the cigarette smoking status of turkish university students. Asian Pac J Cancer Prev, 15, 4527-33.
  27. Poortman, Anne-Right, Kalmijn M (2002). Women's labor market position and divorce in netherlands: evaluating economic interpretations of the work effect. Eur J Popul, 18, 110-29.
  28. Rieker P, Fitzgerald E, Kalish L, et al (1989). Psychosocial factors, curative therapies, and behavioral outcomes. A comparison of testis cancer survivors and a control group of healthy men. Cancer, 64, 2399-407.<2399::AID-CNCR2820641134>3.0.CO;2-P
  29. salvini, Silvana, Vignoli D (2011). Things change: women's and men's marital disruption dynamics in Italy during a time of social transformations, 1970-2003. Demographic Research, 24, 145-74.
  30. Sayer LC, Bianchi SM (2000). Women's Economic Independence and the Probability of Divorce. J Fam Issues, 21, 906-43.
  31. Schoen, Robert, Astone NM, et al (2002). Women's Employment, marital Happiness, and Divorce. Social Forces, 81, 643-62.
  32. Schover L, von Eschenbach A (1985). Sexual and marital relationships after treatment for nonseminomatous testicular cancer. Urology, 25, 251-5.
  33. Shin S, Kim YH, Hwang JS, et al (2014). Economic evaluation of prostate cancer screening test as a national cancer screening program in South Korea. Asian Pac J Cancer Prev, 15, 3383-9.
  34. Socialstyrelsen (2006). In 'Social rapport 2001', in Swedish pp 140-1.
  35. Tuncay T (2014). Coping and quality of life in Turkish women living with ovarian cancer. Asian Pac J Cancer Prev, 15, 4005-12.
  36. Yan J, Pan L, Zhang X, et al (2014). Lack of efficacy of tai chi in improving quality of life in breast cancer survivors: a systematic review and meta-analysis. Asian Pac J Cancer Prev, 15, 3715-20.
  37. Yean-Ju L, (2008). Socioeconomic determinants of divorce/ separation in south Korea: a focus on wife's current and desired employment characteristics. Development and Society, 37, 117-39.
  38. Yu-soon LM-SaK (2005). Factors affecting inclination to divorce with respect to the causes of divorce: a comparison between male and female models. Women's Studies, 69, 35-91

Cited by

  1. Short Sleep Duration and Its Correlates among Cancer Survivors in Korea: the Korea National Health and Nutrition Examination Surveys vol.16, pp.11, 2015,
  2. A Population-Based, Nationwide Cross-Sectional Study on Influenza Vaccination Status among Cancer Survivors in Korea vol.12, pp.8, 2015,