Yakir Rottenberg1, Howard Litwin2, Orly Manor3, Ari Paltiel4, Micha Barchana5, Ora Paltiel6. 1. Dept of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel. Electronic address: ryakir@hadassah.org.il. 2. Paul Baerwald School of Social Work, The Hebrew University of Jerusalem, 91905, Israel. 3. School of Public Health, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel. 4. Central Bureau of Statistics, P.O.B. 34525, Jerusalem 91342, Israel. 5. School of Public Health, Haifa University, Haifa 31905, Israel. 6. School of Public Health, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel; Dept of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel.
Abstract
OBJECTIVES: To assess the association between social networks on survival after cancer diagnosis in a population-based sample of elderly Israelis (>60 yo) living in the community in 1985 and followed for up to 20 years. MATERIALS AND METHODS: We conducted a historical prospective study, using baseline measurements from a 1985 survey of a representative sample of community-dwelling population. Five distinct social networks were defined using information regarding number and intensity of social contacts: traditional-family (reference category), friends and neighbors, narrow-family, diverse, and attenuated. Cancer was ascertained through the Israel Cancer Registry, and mortality through the Population Registry after 20 years of follow-up. RESULTS: The final study population included 676 participants diagnosed with cancer after 1985. Persons in the diverse network showed a lower risk of death (HR=0.74, 95% CI: 0.56-0.98) after adjusting for age, sex, smoking and self-assessed health. On the other hand, poor self-rated health at baseline (HR=1.39, 95% CI: 1.10-1.74 poor vs. all other categories of self-assessed health) was associated with increased risk of death. After excluding cancers amenable to early detection (breast, prostate, and colon) a borderline significant decreased risk of death following a diagnosis of cancer (HR=0.72, 95% CI: 0.52-1.01) was found. CONCLUSION: There is evidence of a significant protective association between diverse social networks present before a cancer diagnosis and survival after the onset of disease. Social support from a variety of sources may be an important element in improving cancer survival in older individuals.
OBJECTIVES: To assess the association between social networks on survival after cancer diagnosis in a population-based sample of elderly Israelis (>60 yo) living in the community in 1985 and followed for up to 20 years. MATERIALS AND METHODS: We conducted a historical prospective study, using baseline measurements from a 1985 survey of a representative sample of community-dwelling population. Five distinct social networks were defined using information regarding number and intensity of social contacts: traditional-family (reference category), friends and neighbors, narrow-family, diverse, and attenuated. Cancer was ascertained through the Israel Cancer Registry, and mortality through the Population Registry after 20 years of follow-up. RESULTS: The final study population included 676 participants diagnosed with cancer after 1985. Persons in the diverse network showed a lower risk of death (HR=0.74, 95% CI: 0.56-0.98) after adjusting for age, sex, smoking and self-assessed health. On the other hand, poor self-rated health at baseline (HR=1.39, 95% CI: 1.10-1.74 poor vs. all other categories of self-assessed health) was associated with increased risk of death. After excluding cancers amenable to early detection (breast, prostate, and colon) a borderline significant decreased risk of death following a diagnosis of cancer (HR=0.72, 95% CI: 0.52-1.01) was found. CONCLUSION: There is evidence of a significant protective association between diverse social networks present before a cancer diagnosis and survival after the onset of disease. Social support from a variety of sources may be an important element in improving cancer survival in older individuals.
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