Impact of marital status at diagnosis on overall survival in patients with anal canal squamous cell carcinoma: a propensity score-matched analysis

Purpose: Marital status has been shown to be an important psychosocial factor that plays an important role in the prognosis of various cancers. The effect of marital status on survival outcomes in anal canal squamous cell carcinoma has not been studied. The purpose of this study was to investigate the effect of marital status on overall survival in anal canal squamous cell carcinoma. Methods According to the established screening criteria, we obtained 2441 patients with anal canal squamous cell carcinoma from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier analysis and multivariate Cox regression analysis were used to analyze the overall survival of anal canal squamous cell carcinoma patients with different marital status. 1:1 propensity score matching (PSM) was used to match 888 unmarried patients with 888 married patients to further demonstrate the effect of marital status on overall survival in patients with anal canal squamous cell carcinoma. Results The 5-year overall survival rates of married, separated/divorced, single and widowed patients with anal canal squamous cell carcinoma were 75.6%, 69.4%, 62.1%and 51.5%, respectively. Multivariate Cox regression analysis indicated that being married was a protective factor for overall survival among anal canal squamous cell carcinoma patients (Divorced/Separated: HR, 1.27; 95% CI, 1.06–1.54; P  = 0.012; Single: HR, 1.31; 95% CI, 1.10–1.55; P  = 0.002; widowed: HR, 1.82; 95% CI, 1.48–2.23; P  < 0.001). Furthermore, married patients were found to have better overall survival than unmarried patients both before and after propensity score matching. Conclusion This study found that married patients with anal canal squamous cell carcinoma had better survival outcomes, while widowed patients had the worst overall survival.