Marriage increases likelihood of screening colonoscopy in men
Married men are more likely to have a screening colonoscopy, especially if their wives are happier with the relationship and more highly educated; however, marital status was not found to affect colonoscopy rates in women, according to a recent study.
“Women are thought to control the health capital in most households,” William Dale, MD, PhD, chief of geriatrics and palliative medicine at University of Chicago, said in a press release. “They act as health gate keepers, overseeing their husband’s health choices and directing decisions at the margins. Her decisions influence both partners. In contrast, women appear to derive fewer direct health benefits from marriage. We suspect they depend more on alternate support sources, such as friends and other relatives.”
Dale and colleagues used a nationally-representative sample including data from 2010 to identify 804 heterosexual married couples from a total sample of 3,137 adults aged 55 to 90 years.
They used a logistic regression model controlling for covariates in the total sample to determine whether marital status is linked to having a colonoscopy, and found that 61% of married men vs. 52% of unmarried men had a colonoscopy in the past 5 years (P = .023), whereas married and unmarried women had comparable colonoscopy rates.
Then, using a bivariate probit regression model in the sample of married couples, they found that men and women are almost twice as likely to have a colonoscopy if their spouse has had one recently (OR = 1.94; 95% CI, 1.39-2.67). Moreover, they found that men are more likely to have a colonoscopy if their wives are happier with the relationship (65% vs. 51%; P = .02), more highly educated (71% college-educated vs. 51% high school-educated; P = .02), and viewed as more supportive (65% vs. 52%; P = .02). Conversely, neither the husband’s happiness with the relationship nor his education level was found to be associated with colonoscopy rates in his wife.
“We suspect that women who are more emotionally invested in their marriage are more likely to encourage healthy behaviors in their husbands,” Dale said in the press release. “Husbands are more likely to take this advice when they view their wives as supportive.”
The researchers concluded that colonoscopy use is highly correlated among married couples, that marriage is associated with greater benefits for men vs. women in terms of colonoscopy rates, and that strategies for increasing colonoscopy use should consider the role of spouses.
“Men don’t like to discuss cancer screening generally or colonoscopies in particular,” Dale said in the press release. “They don’t tend to talk to each other about it. It is not an easy topic of conversation. But our data suggest that they will more often do it with proper encouragement and support from their spouse. Our goal now is to engage the wives, to have them in the office when we discuss cancer screening with the husband.” – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.