A Systematic Review: The Effect of Cancer on the Divorce Rate

Abstract

Introduction: Research on the impact of cancer on close relationships brings up conflicting results. This systematic review collects empirical evidence on the research questions whether a cancer diagnosis in general or the type of cancer affects the divorce rate.

Materials and methods: This systematic review was conducted according to the guidelines of the Cochrane Collaboration and the PRISMA statement. The following electronic databases were searched: Web of Science, Ovid SP MEDLINE, PsycINFO, PsyINDEX, CINAHL, ERIC. Risk of bias assessment was performed with the preliminary risk of bias for exposures tool template (ROBINS-E tool). The grading of methodological quality was assessed with the Newcastle-Ottawa Scale.

Results: Of 13,929 identified records, 15 were included in the qualitative synthesis. In 263,616 cancer patients and 3.4 million healthy individuals, we found that cancer is associated with a slightly decreased divorce rate, except for cervical cancer, which seems to be associated with an increased divorce rate.

Discussion: According to this systematic review, cancer is associated with a tendency to a slightly decreased divorce rate. However, most of the included studies have methodologic weaknesses and an increased risk of bias. Further studies are needed.

Keywords: cancer; couple; divorce; marriage; oncology; psycho-oncology; separation; spouse.

FIGURE 1

PRISMA flow chart.

FIGURE 2

Rating of the methodological quality of the included cohort studies with the NOS (Wells et al., 2020). For the rating of the cross-sectional studies a modified version was used (Herzog et al., 2013). The overall rating scale goes from zero to nine stars (*) for each study (ten stars for cross-sectional studies).