Squamous cell carcinoma of the penis and marital status: Survival study and risk assessment on mortality

摘要

I read with interest the effect of marital status on mortality in patients with squamous cell carcinoma of the penis (SCCP) [1]. Sexual behavior-related factors such as human papillomavirus infection, having sexually transmitted diseases, and the number of sexual partner have been known as the risk of SCCP. The authors mentioned the lack of information on marital status in the last paragraph of "Discussion", and marital status is an important factor to receive health support from his family members. I have a query on their study outcome. The authors clarified that married status is a protective factor on mortality of SCCP. This means that unmarried status becomes a risk factor. On this point, they categorized unmarried status into one group by compiling single, widowed, divorced, or separated men. I previously reported that divorced subjects had a risk of poor self-rated health (SRH), but single or bereaved subjects did not show significant relationship with poor SRH [2]. As poor SRH was a significant risk factor of mortality by overviewing the past reports [3], stratification of unmarried status into several groups should be considered [4]. As the effect of unmarried status on mortality was also affected by activity limitation or poor activity of daily living [5], the additional analysis to check the interaction of variables should be considered.