Women with CRC May Benefit from Larger Social Networks and Increased Social Support

Postmenopausal women with low perceived social support before their diagnosis of colorectal cancer (CRC) have higher overall and CRC-specific mortality, according to a study published in Cancer.

The researchers also indicated that larger social networks, as well as living with someone, may result in a mortality benefit in patients with rectal cancer. 

“These findings support the idea that women who have supportive friends and family around them when they are diagnosed do better,” lead author Candyce Kroenke, MPH, ScD, a research scientist with the Kaiser Permanente Division of Research, said in a press release. “You can and should ask for support instead of going it alone.” 

A cohort of 1,431 women from the Women’s Health initiative who were diagnosed between 1993 and 2017 with stage I through IV CRC, and who responded to the Medical Outcomes Study Social Support survey before their diagnosis, were assessed. Researchers looked at associations of social support and types of support in the participants, as well as associations of social integration and living alone in a subset of 1,141 women.

Women with low (hazard ratio [HR], 1.52; 95% CI, 1.23-1.88) and moderate (HR, 1.21; 95% CI, 0.98-1.50) perceived social support were found to have significantly higher overall morality than those with high support (P [continuous] < 0.001). Likewise, women with low (HR, 1.42; 95% CI, 1.07-1.88) and moderate (HR, 1.28; 95% CI, 0.96-1.70) perceived social support had higher CRC mortality than those with high social support (P [continuous] = 0.007). 

Moreover, emotional, informational, and tangible support and positive interaction were all significantly associated with outcomes, while affection was not. In main-effects analyses, the level of social integration was related to overall mortality (P for trend = 0.02), but not CRC mortality (P for trend = 0.25) and living alone was not associated with mortality outcomes. However, both the level of social integration and living alone were higher overall and were related to outcomes in patients with colorectal cancer. 

“Social support is important to prognosis in women with CRC, and clinicians should collect information on social support in these patients, to link patients to resources and to consider whether clinical care might be modified to accommodate social support needs,” the authors wrote.

The researchers noted that they may have observed a stronger association of social network size and CRC-specific mortality had they had data on close family and friends. Additionally, the potential risks associated with living-alone may be situation-dependent, and the overall association could be a result of mixed effects. Therefore, further research may be necessary to replicate the findings in a larger sample of patients.

Previous studies have shown that women with larger social networks and greater social support have an extended chance of breast cancer survival. Though CRC is the third most common cancer in the US, there is little known about the influence of social support in this population, according to the study. 

References:

1. Kroenke CH, Paskett ED, Cené CW, et al. Prediagnosis Social Support, Social Integration, Living Status, and Colorectal Cancer Mortality in Postmenopausal Women From the Women’s Health Initiative. Cancer. doi:10.1002/cncr.32710.

2. Women with colorectal cancer fare better if they have social support [news release]. Oakland, California. Published January 23, 2020. eurekalert.org/pub_releases/2020-01/kp-wwc012120.php. Accessed January 29, 2020.