- Marital status is a strong risk stratifier: Never-married adults had significantly higher cancer incidence (IRR 1.68 in men; 1.85 in women) across most cancers and populations.
- Largest differences occur in modifiable-risk cancers: The greatest disparities were seen in HPV-related, tobacco-, and alcohol-associated cancers (e.g., anal, cervical, lung, esophageal), suggesting links to behavioral and preventive care factors.
- Risk accumulates over the life course: Associations were stronger at older ages (≥55 years), supporting the role of cumulative social and behavioral exposures rather than early-life differences alone.
- Important racial and sex patterns: Never-married Black men had the highest overall incidence, yet among married men, Black men had lower rates than White men—highlighting potential selection and structural factors.
- Interpret cautiously—association, not causation: Marital status is a proxy for complex factors (e.g., social support, screening, substance use), and the study lacked individual-level behavioral and socioeconomic data.
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