Testosterone levels in women and men who are single, in long-distance relationships, or same-city relationships

Research points to an association between testosterone (T) and partnering in some women and men, and this association has been interpreted as an effect of either relationship status (i.e. differences in relationship status lead to differences in T) or relationship orientation (i.e. T is associated with the likelihood of entering relationships). To address whether physical partner presence was associated with decreased T, we examined T levels in people (72 women; 49 men) who were single, in long-distance relationships, or in same-city relationships. No participants were using exogenous hormones, including hormonal contraceptives. Participants provided a saliva sample and responded to questions about their relationship status. Single men had higher T than long-distance and same-city partnered men, which supports the relationship orientation interpretation. In contrast, same-city partnered women had lower T than single women and women in long-distance relationships, which supports the relationship status interpretation. We conclude that physical partner presence is not necessary to see an association between partnering and hormones in men (since same-city and long-distance partnered men had similar T levels), but may be necessary in women (since same-city partnered women had lower T than long-distance partnered women).     

Sociosexuality moderates the association between testosterone and relationship status in men and women

Single individuals typically have higher testosterone compared to those who are partnered, suggesting that individual differences in testosterone are associated with mating effort, or people's motivation to find a sexual partner. However, there is less consistent evidence for links between testosterone and sociosexuality, or people's orientation toward uncommitted sexual activity. Based on Penke and Asendorpf's (2008) conceptualization, we propose that a more nuanced measure of sociosexuality may reveal more robust associations with testosterone. In the current study, we assessed relations between three components of sociosexuality—desire, behavior, and attitudes—and endogenous testosterone levels in men and women. We found that partnered status was indeed associated with lower testosterone in both men and women, but only among those who reported more restricted sociosexuality. Partnered men who reported greater desire for uncommitted sexual activity had testosterone levels that were comparable to those of single men; partnered women who reported more frequent uncommitted sexual behavior had testosterone levels that were comparable to those of single women. These findings provide new evidence that people's orientations toward sexual relationships, in combination with their relationship status, are associated with individual differences in testosterone. The current results are also among the first to demonstrate sociosexuality-testosterone associations in both men and women, and they reveal that the nature of these associations varies by gender. Together, these findings highlight the utility of a multifaceted conceptualization of sociosexuality and the implications of this conceptualization for neuroendocrine processes.     

Marriage, parenting, and testosterone variation among Kenyan Swahili men

Male variation in testosterone (T) levels may, in part, reflect a differential behavioral allocation to mating and parenting effort. This research tests whether demographic indicators of pair bonding and parenting were associated with salivary T levels among Kenyan Swahili men. Men in the sample were either unmarried (N = 17), monogamously married (N = 57), or polygynously married (N = 14), and between ages 29-52. In contrast with earlier findings among North American men, monogamously married men did not have lower T levels than unmarried men. However, among all married men, men with younger genetic children tended to have marginally lower T levels. Polygynously married men, all of whom had two wives, had higher T levels than all other Swahili men. Possible explanations of higher T levels among polygynously married men are explored.     

Testosterone Levels Are Negatively Associated with Childlessness in Males,but Positively Related to Offspring Count in Fathers

Variation in testosterone (T) is thought to affect the allocation of effort between reproductive and parenting strategies. Here, using a large sample of elderly American men (n = 754) and women (n = 669) we examined the relationship between T and self-reported parenthood, as well as the relationship between T and number of reported children. Results supported previous findings from the literature, showing that fathers had lower T levels than men who report no children. Furthermore, we found that among fathers T levels were positively associated with the number of children a man reports close to the end of his lifespan. Results were maintained when controlling for a number of relevant factors such as time of T sampling, participant age, educational attainment, BMI, marital status and reported number of sex partners. In contrast, T was not associated with either motherhood or the number of children women had, suggesting that, at least in this sample, T does not influence the allocation of effort between reproductive and parenting strategies among women. Findings from this study contribute to the growing body of literature suggesting that, among men, pair bonding and paternal care are associated with lower T levels, while searching and acquiring sex partners is associated with higher T levels.     

Implicit motives and gonadal steroid hormones: effects of menstrual cycle phase,oral contraceptive use,and relationship status

Implicit motives for power and affiliation, salivary levels of testosterone, estradiol, and progesterone, and relationship status were measured in 18 normally cycling (NC) women, 18 women using oral contraceptives (OC), and 18 men at three assessments, corresponding to the menstrual, midcycle, and premenstrual phases of women's menstrual cycle. NC and OC women had elevated levels of affiliation motivation and decreased levels of power motivation at midcycle. Power motive changes were particularly pronounced in NC women across cycle phases. OC women and participants not engaged in an intimate relationship had significantly heightened levels of affiliation motivation, averaged across all cycle phases. Testosterone and power motivation, both averaged across all cycle phases, were positively correlated in men and in single women, but not in women engaged in an intimate relationship. Averaged levels of estradiol and power motivation were positively correlated in engaged women, but not in single women or men. Averaged levels of progesterone and affiliation motivation were negatively correlated in men, and there was evidence for a positive association between luteal affiliation motivation and periovulatory and luteal progesterone in NC women. This study therefore provides evidence that implicit motivational states fluctuate across the menstrual cycle, that the power motive is associated with testosterone and, in women, with estradiol, and that the affiliation motive and progesterone are associated in different ways in men and NC women.     

Reported jealousy differs as a function of menstrual cycle stage and contraceptive pill use: a within-subjects investigation

Previous research suggests that female jealousy is sensitive to hormonal variation and, more specifically, potentially moderated by estrogen levels. Here, we tracked self-reported jealousy using a within-subjects design, comparing jealousy when the same women were regularly cycling and using hormonal contraceptives. Results show that fertile cycle phases are associated with higher levels of jealousy than nonfertile cycle phases in both single and partnered women. However, patterns of jealousy reported when using hormonal contraceptives, as compared to when regularly cycling, differed between single and partnered women. In single women, levels of jealousy while on the pill fell between those reported when fertile and nonfertile but were not significantly different from either. In partnered women, levels of jealousy while using the pill were significantly higher than those reported during the nonfertile cycle phase and similar to those during the brief period of fertility. We discuss possible reasons for differences between single and partnered women in reported jealousy while using the pill. This research is the first to definitively show that a psychological characteristic, for example, jealousy, may be influenced differentially by endogenous hormones vs. exogenous hormones administered via hormonal contraceptives.     

Ethnic differences in hepatic lipase and HDL in Japanese, black, and white Americans: role of central obesity and LIPC polymorphisms

Hepatic lipase activity (HLA) is a determinant of HDL levels, and a polymorphism in the hepatic lipase gene (LIPC) promoter (C-514T) has been hypothesized to account for higher HDL in blacks and Japanese compared with whites. To determine whether the polymorphism contributes to ethnic differences in HDL, we compared LIPC allele frequencies and HLA in Japanese American (JA; n = 84), black American (BA; n = 94), and white American (WA; n = 110) men and women. The LIPC polymorphism was associated with HLA in all cohorts (BA, P = 0.012; JA, P = 0.008; WA, P = 0.009). WA men had 49% and 58% higher HLA than BA and JA men, respectively (both P < 0.05), yet no differences in HLA were found between the women. The higher HLA in the WA men remained after adjustment for the LIPC polymorphism's effect on HLA (P = 0.037) but was erased after adjustment for waist-to-hip-ratio (P = 0.46). Although the WA men had lower HDL and HDL(3) than the JA and BA men (all P < 0.05), there were no differences in HDL(2), implying that variance in HLA may not underlie the ethnic differences in HDL levels. These results suggest that 1) the LIPC promoter polymorphism contributes to variation in HLA and HDL(2) in the three ethnic groups; 2) WA men had higher HLA than BA and JA men, related to ethnic differences in central adiposity but not LIPC allele frequency; and 3) the higher HLA in WA men did not contribute to the ethnic differences in HDL, as the differences in HDL were made up entirely of differences in HDL(3) and not HDL(2).     

Are gonadal steroids linked with orgasm perceptions and sexual assertiveness in women and men?

Past findings suggest links between orgasms and testosterone (T), as well as sexuality and estradiol (E), and we examined hormone–orgasm links in this study via two hypotheses (below). Participants were 86 women and 91 men who provided a saliva sample and completed a demographics questionnaire, the Orgasm Checklist (Mah and Binik, 2002), the Hurlbert (1991) Index of Sexual Assertiveness, and the Sexual Desire Inventory (Spector and Fremeth, 1996). Results supported the first hypothesis of correlations between T and positive orgasm experience in women, specifically with the relaxation, soothing, and peaceful items in both partnered and solitary orgasm contexts. Results also indicated correlations between E and flooding and spreading items in a solitary orgasm context. There were no associations between hormones and men's perceptions of their orgasm experiences. There was no support for the second hypothesis of associations between higher T and more sexual assertiveness. Post hoc analyses showed associations between E and women's sexual desire, and T and men's sexual desire. We discuss implications of these findings including that solitary vs. partnered orgasm experiences may differ, and suggest that T might be associated with perceptions of psychological experiences of orgasms, and E might be associated with perceptions of physical experiences of orgasms.     

Impact of Race/Ethnicity on the Relationship Between Visceral Fat and Inflammatory Biomarkers

The purpose of this study was to determine whether racial/ethnic differences exist in the relationship between visceral adipose tissue (VAT) and selected inflammatory biomarkers. Subjects included 136 African‐American, 133 Hispanic, and 100 white men and women, aged ≥45. Waist circumference and BMI were measured using standard methods. Total VAT, and VAT and subcutaneous adipose tissue (SAT) at the L4L5 spinal level were measured using computed tomography. Interleukin‐6 (IL‐6), C‐reactive protein (CRP), and fibrinogen were measured from fasting blood samples. Results revealed that waist circumference and BMI were similar among groups but African Americans had significantly lower L4L5 VAT compared with Hispanics and whites. Despite lower VAT, African‐American men had similar concentrations of inflammatory biomarkers. On the other hand, African‐American women had higher CRP and IL‐6 than white women, and higher fibrinogen than both Hispanic and white women. After controlling for L4L5 VAT, L4L5 SAT, and age, African‐American women had higher concentrations of IL‐6 and fibrinogen. Stratified analyses for CRP indicated that L4L5 SAT was associated with CRP in African‐American and white women after controlling for L4L5 VAT and age, but that the reverse was not true. These data indicate that African Americans had lower VAT but similar or higher concentrations of inflammatory biomarkers. African‐American women consistently displayed greater inflammation compared with whites, even after controlling for VAT or SAT.     

Dyadic associations between testosterone and relationship quality in couples

Testosterone is thought to be positively associated with “mating effort”, or the initiation and establishment of sexual relationships (Wingfield et al., 1990). Yet, because testosterone is negatively associated with nurturance (van Anders et al., 2011), high levels of testosterone may be incompatible with relationship maintenance. For instance, partnered men with high testosterone report lower relationship quality compared to partnered men with low testosterone (e.g., Booth and Dabbs, 1993). Findings for women are inconsistent, however, and even less is known about potential dyadic associations between testosterone and relationship quality in couples. In the current report, we assessed relationship satisfaction, commitment, and investment in heterosexual couples and tested the hypothesis that these aspects of relationship quality would be negatively associated with an individual's own and his/her partner's testosterone levels. We found that testosterone was in fact negatively associated with relationship satisfaction and commitment in both men and women. There was also evidence for dyadic associations: Participants' satisfaction and commitment were negatively related to their partners' levels of testosterone, and these associations were larger for women's than men's testosterone. Our findings are consistent with the idea that high testosterone may be incompatible with the maintenance of nurturant relationships. The current findings also provide some of the first evidence for dyadic associations between testosterone and relationship quality in couples, highlighting the interdependent nature of close relationship processes and the importance of considering this interdependence in social neuroendocrine research.     

The lipid accumulation product is associated with increased mortality in normal weight postmenopausal women

Lipid accumulation product (LAP) is an emerging cardiovascular risk factor, which is calculated from waist circumference (WC) and triglyceride (TG) levels. The aim of this study was to elucidate the relationship between LAP and cardiovascular mortality as well as the presence of type 2 diabetes with respect to gender-specific differences. We determined WC and fasting TG levels and the cardiovascular and metabolic phenotypes coronary artery disease (CAD), hypertension, metabolic syndrome, and diabetes mellitus in 2,279 men and 875 postmenopausal women who were routinely referred to coronary angiography. The LAP was calculated as (WC (cm)--65) × (TG (mmol/l)) for men and as (WC (cm)--58) × (TG (mmol/l)) for women. LAP levels were independently associated with congestive heart failure mortality in all postmenopausal women and with all-cause mortality in diabetic postmenopausal women but not in men. Multivariable-adjusted hazard ratios (with 95% confidence intervals) for all-cause, cardiovascular, and congestive heart failure mortality in the third compared to the first LAP tertile were 4.28 (1.94-9.44; P < 0.001), 3.47 (1.28-9.40; P = 0.015), and 10.77 (1.21-95.88; P = 0.033), respectively, in normal weight postmenopausal women, whereas no significant associations were found in men. LAP levels were highly associated with type 2 diabetes in all subjects, postmenopausal women, and men. High LAP values are predictive of mortality independently of other cardiovascular risk factors in normal weight and diabetic postmenopausal women but not in men. Type 2 diabetes (T2DM) was highly associated with LAP in women and men. Our study validates an inexpensive and simple risk profiling that may allow identifying postmenopausal women at high cardiovascular risk.     

Hepatic lipase C514T polymorphism and its relationship with plasma HDL-C levels and coronary artery disease in Koreans

Hepatic lipase is a key enzyme that is involved in HDL-C metabolism. The goal of this study was to find out the frequency of the hepatic lipase C514T polymorphism, and evaluate its relationship with plasma HDL-C levels and coronary artery disease (CAD) in Koreans. Two hundred and twenty four subjects with no previous history of lipid-lowering therapy, 118 patients with significant CAD, and 106 controls were examined with respect to their genotypes, lipid profiles, and other risk factors for CAD. The frequency of the -514T allele was 0.37 in men and 0.35 in women, which were higher than the frequency that was reported in Caucasians, but lower than the frequency that was reported in African-Americans. The -514T allele was associated with significantly higher HDL-C levels in women. After controlling for age, gender, BMI, DM, and smoking, the non-CC genotype was significantly associated with HDL-C levels, and explained 6% of the HDL-C variation in this study. When the genotypes-distribution was compared between the CAD and non-CAD patients, the hepatic lipase C-514T polymorphism was not associated with the presence of CAD. Koreans have a higher frequency of the hepatic lipase gene 514T allele than Caucasians, and the -514T allele is associated with higher plasma HDL-C levels in Korean women, and perhaps non-smoking men. However, our data does not suggest an association between the polymorphism and an increased risk of CAD.     

Infection with multiple human immunodeficiency virus type 1 variants is associated with faster disease progression

Human immunodeficiency virus type 1 (HIV-1)-infected individuals develop a genetically diverse virus population over time, but often only a limited number of viral variants are transmitted from a chronic carrier to a newly infected person. Interestingly, many women but few men are infected by multiple HIV-1 variants from a single partner. To determine whether the complexity of the infecting virus population influences clinical outcome, we examined viral diversity in the HIV-1 envelope sequences present at primary infection in 156 women from Kenya for whom we had follow-up data on viral RNA levels and CD4 T-cell counts. Eighty-nine women had multiple viral genotypes, while 67 women had a single genotype at primary infection. Women who acquired multiple viral genotypes had a significantly higher viral load (median, 4.84 versus 4.64 log(10) copies/ml, P = 0.04) and a significantly lower CD4(+)-T-cell count (median, 416 versus 617 cells/mm(3), P = 0.01) 4 to 24 months after infection compared to women who were infected with a single viral genotype. These studies suggest that early HIV-1 genetic diversity is linked to faster disease progression.     

Testosterone and partnering are linked via relationship status for women and ‘relationship orientation’ for men

Cross-cultural evidence links pair bonding and testosterone (T). We investigated what factors account for this link, how casual relationships are implicated, and whether gender/sex moderates these patterns in a North American sample. We gathered saliva samples for radioimmunoassay of T and self-report data on background, health, and social/relational variables from 115 women and 120 men to test our predictions, most of which were supported. Our results show that singles have higher T than long-term (LT) partnered individuals, and that casual relationships without serious romantic commitment are more like singlehood for men and LT relationships for women–in terms of T. We were also able to demonstrate what factors mediate the association between partnering and T: in women, frequency of partnered sexual activity mediated the effect in men, interest in more/new partners mediated the effect. This supported our prediction of relationship status interpretations in women, but relationship orientation in men. Results replicated past findings that neither sexual desire nor extrapair sexuality underlie the T-partnering link. We were able to rule out a large number of viable alternative explanations ranging from the lifestyle (e.g., sleep) to the social (e.g., social support). Our data thus demonstrate pattern and mediators for the development of T-pair bonding associations, and emphasize the importance of neither under- nor overstating the importance of gender/sex in research about the evolution of intimacy.     

Relationship Status and Relationship Instability,but Not Dominance,Predict Individual Differences in Baseline Cortisol Levels

We investigated variation in baseline cortisol levels in relation to relationship status (single or in a relationship), relationship characteristics (length, stability, presence or absence of clear dominance), or individual attributes (dominant or subordinate status, relative physical attractiveness, relationship worries). Study participants were 77 men and 75 women aged between 18 and 38 years. Individuals in romantic relationships had lower cortisol levels than singles. Individuals of African ethnicity, however, showed the opposite pattern. Individuals who perceived their relationship to be highly unstable had higher cortisol levels. Aside from African-Americans, married individuals reported the lowest relationship instability and the lowest cortisol levels, followed by individuals in long-term relationships, and by individuals in short-term relationships. The presence or absence of clear dominance in the relationship, dominance status, or relationship worries did not affect cortisol levels. Therefore relationship status and relationship instability were better predictors of variation in cortisol (presumably through stress-related mechanisms) than individual attributes.     

Suicide among Arab-Americans

Background

Arab-American (AA) populations in the US are exposed to discrimination and acculturative stress—two factors that have been associated with higher suicide risk. However, prior work suggests that socially oriented norms and behaviors, which characterize recent immigrant ethnic groups, may be protective against suicide risk. Here we explored suicide rates and their determinants among AAs in Michigan, the state with the largest proportion of AAs in the US.

Methodology/Principal Findings

ICD-9/10 underlying cause of death codes were used to identify suicide deaths from among all deaths in Michigan between 1990 and 2007. Data from the 2000 U.S. Census were collected for population denominators. Age-adjusted suicide rates among AAs and non-ethnic whites were calculated by gender using the direct method of standardization. We also stratified by residence inside or outside of Wayne County (WC), the county with the largest AA population in the state. Suicide rates were 25.10 per 100,000 per year among men and 6.40 per 100,000 per year among women in Michigan from 1990 to 2007. AA men had a 51% lower suicide rate and AA women had a 33% lower rate than non-ethnic white men and women, respectively. The suicide rate among AA men in WC was 29% lower than in all other counties, while the rate among AA women in WC was 20% lower than in all other counties. Among non-ethnic whites, the suicide rate in WC was higher compared to all other counties among both men (12%) and women (16%).

Conclusions/Significance

Suicide rates were higher among non-ethnic white men and women compared to AA men and women in both contexts. Arab ethnicity may protect against suicide in both sexes, but more so among men. Additionally, ethnic density may protect against suicide among Arab-Americans.     

Effects of affiliation and power motivation arousal on salivary progesterone and testosterone

Following up on earlier research suggesting a link between implicit affiliation motivation and progesterone (P) and implicit power motivation and testosterone [T; Schultheiss, O.C., Dargel, A., Rohde, W., 2003. Implicit motives and gonadal steroid hormones: Effects of menstrual cycle phase, oral contraceptive use, and relationship status. Horm. Behav. 43, 293-301.], we tested whether arousal of affiliation motivation increases P levels and whether arousal of power motivation increases T levels. Sixty subjects were randomly assigned to watch 30 min of either Bridges of Madison County (affiliation arousal) or The Godfather II (power arousal), or a documentary about the Amazon (control condition). Levels of P and T were assessed in saliva samples taken before (T1), immediately after (T2), and 45 min after the movie (T3). The efficacy of experimental conditions to differentially arouse motives was verified by assessment of changes in affiliation and power motive imagery expressed in imaginative stories written before and after the movie. After the movie, salivary P levels (T2 and T3) in the affiliation-arousal group were significantly higher than in the control group and marginally higher than in the power-arousal group. Subjects' postmovie T responses (T3) depended on premovie T levels: in men, higher premovie T levels predicted a greater likelihood of postmovie T increases in the Power Arousal condition but not in the other conditions, whereas in women, higher premovie T levels tended to be associated with postmovie T decreases in the Power Arousal condition but not in the other conditions. These findings suggest that aroused affiliation motivation has a specific stimulatory effect on P, whereas aroused power motivation has a specific stimulatory effect on T in men, but not in women, with high baseline T levels.     

Work stress, obesity and the risk of type 2 diabetes: gender-specific bidirectional effect in the Whitehall II study

Psychosocial work stress has been linked to higher risk of type 2 diabetes (T2DM), with the effect being consistently higher among women than men. Also, work stress has been linked to prospective weight gain among obese men but weight loss among lean men. Here, we aimed to examine the interaction between work stress and obesity in relation to T2DM risk in a gender‐specific manner. We studied 5,568 white middle‐aged men and women in the Whitehall II study, who were free from diabetes at analysis baseline (1993). After 1993, diabetes was ascertained at six consecutive phases by an oral glucose tolerance test supplemented by self‐reports. Cox regression analysis was used to assess the association between job strain (high job demands/low job control) and 18‐year incident T2DM stratifying by BMI (BMI <30 kg/m² vs. BMI ≥30 kg/m²). Overall, work stress was associated with incident T2DM among women (hazard ratio (HR) 1.41: 95% confidence intervals: 1.02; 1.95) but not among men (HR 0.87: 95% confidence interval 0.69; 1.11) (P_INTERACTION = 0.017). Among men, work stress was associated with a lower risk of T2DM in nonobese (HR 0.70: 0.53; 0.93) but not in obese individuals (P_INTERACTION = 0.17). Among women, work stress was associated with higher risk of T2DM in the obese (HR 2.01: 1.06; 3.92) but not in the nonobese (P_INTERACTION = 0.005). Gender and body weight status play a critical role in determining the direction of the association between psychosocial stress and T2DM. The potential effect‐modifying role of gender and obesity should not be ignored by future studies looking at stress‐disease associations.     

Testosterone and partnering are linked via relationship status for women and ‘relationship orientation’ for men

Cross-cultural evidence links pair bonding and testosterone (T). We investigated what factors account for this link, how casual relationships are implicated, and whether gender/sex moderates these patterns in a North American sample. We gathered saliva samples for radioimmunoassay of T and self-report data on background, health, and social/relational variables from 115 women and 120 men to test our predictions, most of which were supported. Our results show that singles have higher T than long-term (LT) partnered individuals, and that casual relationships without serious romantic commitment are more like singlehood for men and LT relationships for women–in terms of T. We were also able to demonstrate what factors mediate the association between partnering and T: in women, frequency of partnered sexual activity mediated the effect in men, interest in more/new partners mediated the effect. This supported our prediction of relationship status interpretations in women, but relationship orientation in men. Results replicated past findings that neither sexual desire nor extrapair sexuality underlie the T-partnering link. We were able to rule out a large number of viable alternative explanations ranging from the lifestyle (e.g., sleep) to the social (e.g., social support). Our data thus demonstrate pattern and mediators for the development of T-pair bonding associations, and emphasize the importance of neither under- nor overstating the importance of gender/sex in research about the evolution of intimacy.     

Marital status and colon cancer outcomes in US Surveillance, Epidemiology and End Results registries: does marriage affect cancer survival by gender and stage?

Background: Marital status has been associated with outcomes in several cancer sites including breast cancer in the literature, but little is known about colon cancer, the fourth most common cancer in the US. Methods: A total of 127,753 patients with colon cancer were identified who were diagnosed between 1992 and 2006 in the US Surveillance, Epidemiology and End Results (SEER) Program. Marital status consisted of married, single, separated/divorced and widowed. Chi-square tests were used to examine the association between marital status and other variables. The Kaplan–Meier method was used to estimate survival curves. Cox proportional hazards models were fit to estimate the effect of marital status on survival. Results: Married patients were more likely to be diagnosed at an earlier stage (and for men also at an older age) compared with single and separated/divorced patients, and more likely to receive surgical treatment than all other marital groups (all p < 0.0001). The five-year survival rate for the single was six percentage points lower than the married for both men and women. After controlling for age, race, cancer stage and surgery receipt, married patients had a significantly lower risk of death from cancer (for men, HR: 0.86, CI: 0.82–0.90; for women, HR: 0.87, CI: 0.83–0.91) compared with the single. Within the same cancer stage, the survival differences between the single and the married were strongest for localized and regional stages, which had overall middle-range survival rates compared to in situ or distant stage so that support from marriage could make a big difference. Conclusions: Marriage was associated with better outcomes of colon cancer for both men and women, and being single was associated with lower survival rate from colon cancer.