Journal
JOURNAL OF CANCER SURVIVORSHIP-RESEARCH AND PRACTICE
Volume 4, Issue 4, Pages 372-380Publisher
SPRINGER
DOI: 10.1007/s11764-010-0139-5
Keywords
Cancer; Oncology; Breast cancer; Survival; Mortality; Social networks
Categories
Funding
- Susan B. Komen For the Cure Foundation [POP 0504234]
- NIH [CA47147, CA47305]
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Introduction Evidence has been inconsistent regarding the impact of social networks on survival after breast cancer diagnosis. We prospectively examined the relation between components of social integration and survival in a large cohort of breast cancer survivors. Methods Women (N=4,589) diagnosed with invasive breast cancer were recruited from a population-based, multi-center, case-control study. A median of 5.6 years (Interquartile Range 2.7-8.7) after breast cancer diagnosis, women completed a questionnaire on recent post-diagnosis social networks and other lifestyle factors. Social networks were measured using components of the Berkman-Syme Social Networks Index to create a measure of social connectedness. Based on a search of the National Death Index, 552 deaths (146 related to breast cancer) were identified. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. Results Higher scores on a composite measure of social connectedness as determined by the frequency of contacts with family and friends, attendance of religious services, and participation in community activities was associated with a 15-28% reduced risk of death from any cause (p-trend=0.02). Inverse trends were observed between all-cause mortality and frequency of attendance at religious services (p-trend=0.0001) and hours per week engaged in community activities (p-trend=0.0005). No material associations were identified between social networks and breast cancer-specific mortality. Conclusions Engagement in activities outside the home was associated with lower overall mortality after breast cancer diagnosis.
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