Early-stage breast cancer is not associated with the risk of marital dissolution in a large prospective study of women

Background: As breast cancer and its treatment are likely to interfere with traditional expectations of womanhood, it may affect marital stability. Methods: The risk of marital dissolution was analysed with respect to diagnosis of early-stage (T1-4N0-3M0) breast cancer in a cohort of 134 435 married Finnish women followed for a median of 17.0 married years. Age, socioeconomic status, education, number of children, duration of marriage and earlier marriages were taken into account and the effects of surgery, chemotherapy, radiotherapy and endocrine therapy were analysed separately. Results: Women with a diagnosis of early-stage breast cancer did not show increase in marital dissolution (hazard ratio -0.96, 95% confidence interval = 0.79-1.17). Neither the type of surgical procedure nor any of the oncologic treatments was associated with an increase in the risk of divorce. Conclusions: Any evidence of excess risk of marital breakdown after the diagnosis of early-stage breast cancer and its treatment was not demonstrated.Peer reviewe

Second thoughts about implementing routine screening of cancer patients for distress

Recommendations for routine screening of cancer patients for distress lack evidence that screening improves patient outcomes. Settings contemplating screening should consider other options for using the same resources. This article reviews evidence relevant to decision making and calls attention to limits in using screening instruments cross-culturally and for triaging patients for receipt of services. Whether screening is the best option depends on the patient population, culture, and health system