Abstract
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.
Data availability
The data used in this study are publicly available from the SEER database (http://www.seer.cancer.gov) upon reasonable request. The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.
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Conceptualization and methodology, Rupin Chen and Honggeng Wang; writing—original draft preparation, Rongbing Jiang and Zhiying Yao; writing—review and editing, Zhiying Yao; validation, Qingquan Chen; formal analysis, Shangbin Huang; data curation, Rongrong Dai and Qingquan Chen. All authors have read and agreed to the published version of the manuscript.
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The SEER database provides publicly available data for this study, which means that obtaining informed consent from participants or ethical approval from an institutional review board is not necessary. We obtained access to the 1979–2019 SEER Research Data File by signing a Data-Use Agreement that outlines the terms and conditions for access.
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Yao, Z., Jiang, R., Dai, R. et al. Investigating the association between marital status and survival outcomes in patients with follicular thyroid carcinoma: a population-based analysis. Sci Rep (2026). https://doi.org/10.1038/s41598-026-47247-6
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DOI: https://doi.org/10.1038/s41598-026-47247-6
