Investigating the association between marital status and survival outcomes in patients with follicular thyroid carcinoma: a population-based analysis

Follicular thyroid carcinoma (FTC) represents a distinct subtype of thyroid malignancy; however, the prognostic significance of marital status, a recognized social determinant in various other cancers, remains inadequately characterized within this specific patient population. This retrospective cohort study leveraged data from the Surveillance, Epidemiology, and End Results (SEER) database to explore the relationship between marital status and survival outcomes among 7954 patients diagnosed with FTC from 2004 to 2015. Patients were classified as either married or unmarried, and overall survival (OS) as well as cancer-specific survival (CSS) were assessed using Kaplan-Meier analysis, log-rank tests, and Cox proportional hazards models. To address potential confounding variables, propensity score matching (PSM) was utilized, and further subgroup analyses were conducted based on age and sex. Prior to and following PSM, unmarried patients exhibited significantly inferior OS and CSS compared to their married counterparts (all P < 0.05). After PSM, unmarried status was found to be independently associated with poorer OS (HR 1.52, 95% CI 1.34–1.74, P < 0.001) and CSS (HR 1.58, 95% CI 1.23–2.03, P < 0.001) after multivariate adjustment. A significant interaction between marital status and age was identified (P for interaction = 0.02), with the beneficial effects of married status on survival outcomes being particularly pronounced among patients aged 65 years and older (HR 0.63, 95% CI 0.48–0.83), while no significant interaction was noted with respect to sex. This extensive population-based analysis underscores marital status as an independent prognostic factor in FTC, highlighting the potential importance of social support systems in the holistic management of these patients.