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November 17, 1989, Vol 262, No. 19 >
ARTICLE | November 17, 1989

Marriage and Divorce After Childhood and Adolescent Cancer FREE

Julianne Byrne, PhD; Thomas R. Fears, PhD; Sandra C. Steinhorn, MPH; John J. Mulvihill, MD; Roger R. Connelly, MS; Donald F. Austin, MD, MPH; Grace F. Holmes, MD; Frederick F. Holmes, MD; Howard B. Latourette, MD; M. Jane Teta, DrPH; Louise C. Strong, MD; Max H. Myers, PhD
[+] Author Affiliations

Reprint requests to the Clinical Epidemiology Branch, Executive Plaza North, Room 400, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892 (Dr Byrne).


JAMA. 1989;262(19):2693-2699. doi:10.1001/jama.1989.03430190077035
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As part of a study of long-term survivors of childhood and adolescent cancer, we interviewed 2170 survivors and 3138 sibling control subjects about their marital histories. In a proportional hazards analysis, both male and female survivors were less likely to be ever married than control subjects (rate ratio [RR] for males, 0.87; 99% confidence interval, 0.76 to 0.99; RR for females, 0.86; 99% confidence interval, 0.76 to 0.97). Survivors of brain and central nervous system tumors accounted for most of the marriage deficit, which was greater in men than in women (RRs, 0.48 and 0.73, respectively). Survivors married at the same average age as control subjects, except for survivors of central nervous system tumors, who married slightly later. The average length of first marriages was shorter in survivors than in control subjects. Men who had survived central nervous system tumors diagnosed before 10 years of age and male survivors of retinoblastoma had higher divorce rates than male control subjects (RRs, 2.9 and 1.9, respectively). In this cohort (which received less intense therapy than given in current practice), altered marriage practices are substantial only among survivors of central nervous system tumors.

(JAMA. 1989;262:2693-2699)

REFERENCES

1 +
Li FP, Stone R.  Survivors of cancer in childhood . Ann Intern Med. 1976;;84:551-553.
2 +
Holmes HA, Holmes FF.  After ten years, what are the handicaps and life styles of children treated for cancer? Clin Pediatr. 1975;;14:819-823.
3 +
Koocher GP, O'Malley JE. The Damocles Syndrome: Psychosocial Consequences of Surviving Childhood Cancer . New York, NY: McGraw-Hill International Book Co; 1981;.
4 +
Carter H, Glick PC. Marriage and Divorce: A Social and Economic Study . Cambridge, Mass: Harvard University Press; 1970;.
5 +
Cox DR.  Regression models and life tables (with discussion) . J R Stat Soc Series B. 1972;;34:187-220.
6 +
Lee ET. Statistical Methods for Survival Data Analysis . Belmont, Calif: Lifetime Learning Publications; 1980;.
7 +
Kaplan EL, Meier P.  Nonparametric estimation from incomplete observations . J Am Stat Assoc. 1958;;53:457-481.
8 +
Harrell FE Jr. The PHGLM Procedure: SUGI Supplemental Library User's Guide. Version 5 ed. Cary, NC: SAS Institute Inc; 1986.
9 +
Kelaghan J, Myers MH, Mulvihill JJ, et al.  Educational achievement in longtime survivors of childhood and adolescent cancers . Med Pediatr Oncol. 1988;;16:320-326.
10 +
Byrne J.  The impact of selected psychosocial factors on the reproductive choices of long-term survivors of childhood and adolescent cancer . In: Mulvihill JJ, Sherins RE, eds. Reproduction and Human Cancer . New York, NY: Raven Press. In press.
11 +
Young JL, Gloeckler L, Silverberg E, et al.  Cancer incidence, survival, and mortality for children younger than age 15 years . Cancer. 1987;;58:598-602.
12 +
Marital Status and Living Arrangements: March 1985 . Washington, DC: US Bureau of the Census; 1986;. Current Population Reports, Series P-20, No. (410) .
13 +
Bamford FN, Morris Jones P, Pearson D, et al.  Residual disabilities in children treated for intracranial space-occupying lesions . Cancer. 1976;;37: 1149-1151.
14 +
Duffner PK, Cohen ME, Thomas PRM, Lansky SB.  The long-term effects of cranial irradiation on the central nervous system . Cancer. 1985;;56:1841-1846.
15 +
Danoff BF, Cowchock FS, Marquette C, et al.  Assessment of the long-term effects of primary radiation therapy for brain tumors in children . Cancer. 1982;;49:1580-1586.
16 +
Seidel UP, Chadwick OFD, Rutter M.  Psychological disorders in crippled children: a comparative study of children with and without brain damage . Dev Med Child Neurol. 1975;;17:563-573.
17 +
Chin HW, Maruyama Y.  Age at treatment and long-term performance results in medulloblastoma . Cancer. 1984;;53:1952-1958.
18 +
Mostow EN, Byrne J, Connelly RR, Mulvihill JJ.  Quality of life in long-term survivors of central nervous system (CNS) tumors in childhood and adolescence . Proc AACR 1989;;30:313.
19 +
Horning SJ, Hoppe RT, Kaplan HS, Rosenberg SA.  Female reproductive potential after treatment for Hodgkin's disease . N Engl J Med. 1981;;304:1377-1382.
20 +
Byrne J, Mulvihill JJ, Myers MH, et al.  Effects of treatment on fertility in long-term survivors of childhood or adolescent cancer . N Engl J Med. 1987;;317:1315-1321.
21 +
Wasserman AL, Thompson EI, Wilimas JA, Fairclough DL.  The psychological status of survivors of childhood/adolescent Hodgkin's disease . AJDC . 1987;;141:626-631.
22 +
Cassileth BR, Lusk EJ, Strouse TB, et al.  A psychological analysis of cancer patients and their next-of-kin . Cancer. 1985;;55;72-76.
23 +
Teta MJ, Del Po MC, Kasl SV, et al.  Psychosocial consequences of childhood and adolescent cancer survival . J Chronic Dis. 1986;;39:751-759.
24 +
Trump DL, Romsaas EP, Cummings KC, Malec JF.  Assessment of psychologic and sexual dysfunction in patients following treatment of testis cancer: a prospective study . Proc ASCO. 1985;; 4:250.
25 +
Tross S, Holland JC, Bosl G, Geller N.  A controlled study of psychosocial sequelae in cured survivors of testicular neoplasms . Proc ASCO. 1984;;3:74.
26 +
Rieker PP, Edbril SD, Garnick MB.  Curative testis cancer therapy: psychosocial sequelae . J Clin Oncol. 1985;;3:1117-1126.
27 +
Teta MJ. A Psychosocial Assessment of Childhood and Adolescent Cancer Survival. New Haven, Conn: Yale University; 1987. Dissertation.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Li FP, Stone R.  Survivors of cancer in childhood . Ann Intern Med. 1976;;84:551-553.
2 +
Holmes HA, Holmes FF.  After ten years, what are the handicaps and life styles of children treated for cancer? Clin Pediatr. 1975;;14:819-823.
3 +
Koocher GP, O'Malley JE. The Damocles Syndrome: Psychosocial Consequences of Surviving Childhood Cancer . New York, NY: McGraw-Hill International Book Co; 1981;.
4 +
Carter H, Glick PC. Marriage and Divorce: A Social and Economic Study . Cambridge, Mass: Harvard University Press; 1970;.
5 +
Cox DR.  Regression models and life tables (with discussion) . J R Stat Soc Series B. 1972;;34:187-220.
6 +
Lee ET. Statistical Methods for Survival Data Analysis . Belmont, Calif: Lifetime Learning Publications; 1980;.
7 +
Kaplan EL, Meier P.  Nonparametric estimation from incomplete observations . J Am Stat Assoc. 1958;;53:457-481.
8 +
Harrell FE Jr. The PHGLM Procedure: SUGI Supplemental Library User's Guide. Version 5 ed. Cary, NC: SAS Institute Inc; 1986.
9 +
Kelaghan J, Myers MH, Mulvihill JJ, et al.  Educational achievement in longtime survivors of childhood and adolescent cancers . Med Pediatr Oncol. 1988;;16:320-326.
10 +
Byrne J.  The impact of selected psychosocial factors on the reproductive choices of long-term survivors of childhood and adolescent cancer . In: Mulvihill JJ, Sherins RE, eds. Reproduction and Human Cancer . New York, NY: Raven Press. In press.
11 +
Young JL, Gloeckler L, Silverberg E, et al.  Cancer incidence, survival, and mortality for children younger than age 15 years . Cancer. 1987;;58:598-602.
12 +
Marital Status and Living Arrangements: March 1985 . Washington, DC: US Bureau of the Census; 1986;. Current Population Reports, Series P-20, No. (410) .
13 +
Bamford FN, Morris Jones P, Pearson D, et al.  Residual disabilities in children treated for intracranial space-occupying lesions . Cancer. 1976;;37: 1149-1151.
14 +
Duffner PK, Cohen ME, Thomas PRM, Lansky SB.  The long-term effects of cranial irradiation on the central nervous system . Cancer. 1985;;56:1841-1846.
15 +
Danoff BF, Cowchock FS, Marquette C, et al.  Assessment of the long-term effects of primary radiation therapy for brain tumors in children . Cancer. 1982;;49:1580-1586.
16 +
Seidel UP, Chadwick OFD, Rutter M.  Psychological disorders in crippled children: a comparative study of children with and without brain damage . Dev Med Child Neurol. 1975;;17:563-573.
17 +
Chin HW, Maruyama Y.  Age at treatment and long-term performance results in medulloblastoma . Cancer. 1984;;53:1952-1958.
18 +
Mostow EN, Byrne J, Connelly RR, Mulvihill JJ.  Quality of life in long-term survivors of central nervous system (CNS) tumors in childhood and adolescence . Proc AACR 1989;;30:313.
19 +
Horning SJ, Hoppe RT, Kaplan HS, Rosenberg SA.  Female reproductive potential after treatment for Hodgkin's disease . N Engl J Med. 1981;;304:1377-1382.
20 +
Byrne J, Mulvihill JJ, Myers MH, et al.  Effects of treatment on fertility in long-term survivors of childhood or adolescent cancer . N Engl J Med. 1987;;317:1315-1321.
21 +
Wasserman AL, Thompson EI, Wilimas JA, Fairclough DL.  The psychological status of survivors of childhood/adolescent Hodgkin's disease . AJDC . 1987;;141:626-631.
22 +
Cassileth BR, Lusk EJ, Strouse TB, et al.  A psychological analysis of cancer patients and their next-of-kin . Cancer. 1985;;55;72-76.
23 +
Teta MJ, Del Po MC, Kasl SV, et al.  Psychosocial consequences of childhood and adolescent cancer survival . J Chronic Dis. 1986;;39:751-759.
24 +
Trump DL, Romsaas EP, Cummings KC, Malec JF.  Assessment of psychologic and sexual dysfunction in patients following treatment of testis cancer: a prospective study . Proc ASCO. 1985;; 4:250.
25 +
Tross S, Holland JC, Bosl G, Geller N.  A controlled study of psychosocial sequelae in cured survivors of testicular neoplasms . Proc ASCO. 1984;;3:74.
26 +
Rieker PP, Edbril SD, Garnick MB.  Curative testis cancer therapy: psychosocial sequelae . J Clin Oncol. 1985;;3:1117-1126.
27 +
Teta MJ. A Psychosocial Assessment of Childhood and Adolescent Cancer Survival. New Haven, Conn: Yale University; 1987. Dissertation.

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