Less Partnering, Less Children, or Both? Analysis of the Drivers of First Birth Decline in Finland Since 2010

Cohabitation and Marriage Formation in Times of Fertility Decline: The Case of Sweden in the Twenty-First Century

Developments over time in the prevalence of marriage and cohabitation formation has long received much interest, but less is known about more recent developments for different population subgroups in European countries. This applies as well to Sweden, a country considered a forerunner in family-demographic change. In contrast, much attention has been paid to the falling birth rates during the 2010s, and explanations that focus on the role of increasing uncertainties. In the Swedish case, the fertility decline has been documented across all main socio-demographic subgroups. The objective of this study is to examine whether the same situation holds for first marriage and cohabitation formation during the 2010s and the exceptional years of the Covid-19 pandemic. Based on Swedish population registers, including with new cohabitation data, we present annual indices of first marriage formation (1991-2022) and cohabitation formation (2012-2022) across a number of socio-demographic strata. We demonstrate a continuous decline in first marriage formation since the early 2010s with an additional sharp dip during the pandemic and a post-pandemic recovery. In contrast, there was a remarkable stability in cohabitation formation during 2012-2022. Although socio-demographic groups differ in their overall levels of marriage and cohabitation formation, the recent trends are strikingly similar across groups. Cohabiting couples, across population subgroups, have become less inclined to transition their union status to a more committed level, as manifested by marriage or parenthood. This occurred in spite of a positive economic climate in the 2010s and stable family policies, indicating that other forces are at play.

Partnership dynamics and entry into parenthood: Comparison of Finnish birth cohorts 1969-2000

During the past decade, the stability of close-to-replacement-level fertility ended in all Nordic countries, with its decline to the lowest level in Finland. It is unclear whether and how partnership dynamics have changed, and whether they play a role in fertility developments. We focus on the patterns and associations between the formation and stability of co-residential partnerships and first birth among Finnish women and men, and on whether and how these associations have changed across birth cohorts. We utilise total population register data on persons born between 1969 and 2000 in Finland, and adopt the event history method. Our results indicate that half of the women formed their first co-residential partnerships by the age of 22 years. Cohorts born in the early 1990s were the first to delay the formation of non-marital first partnerships. In contrast, first births are increasingly postponed, and the proportion of women and men, who become parents, has declined across recent cohorts. Among men, we observe higher median ages for family formation events and higher likelihoods of not forming a family. As a result of fertility decline and increase in partnership instability, for the first time, the probability of separation is higher than that of first births among partnered women born in the 1990s. Our findings show that at a behavioural level, the once close link between partnership formation and parenthood has progressively eroded across consecutive birth cohorts. Together with the ongoing tendency to delay first births, decreasing partnership stability, and first indications of delaying partnership formation, the potential of witnessing a marked increase of fertility levels in the near future is delimited. Our study's results contribute to a better understanding of the demographic mechanisms behind the decline in fertility in Finland, over the recent decade.

Web-Based Dynamic Nomograms for Predicting Overall Survival and Cancer-Specific Survival in Breast Cancer Patients with Lung Metastases

BACKGROUND

60-70% of patients who die from breast cancer have lung metastases. However, there is a lack of readily available tools for accurate risk stratification in patients with breast cancer lung metastases (BCLM). Therefore, a web-based dynamic nomogram was developed for BCLM to quickly, accurately, and intuitively assess overall and cancer-specific survival rates.

METHODS

Patients diagnosed with BCLM between 2004 and 2016 were extracted from the Surveillance, Epidemiology, and Final Results (SEER) database. After excluding incomplete data, all patients were randomly assigned to training and validation cohorts (2:1). Patients' basic clinical information, detailed pathological staging and treatment information, and sociological information were included in further analysis. Nomograms were constructed following the evaluations of the Cox regression model and verified using the concordance index (C-index), calibration curves, time-dependent receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Web-based dynamic nomograms were published online.

RESULTS

3916 breast cancer patients with lung metastases were identified from the SEER database. Based on multivariate Cox regression analysis, overall survival (OS) and cancer-specific survival (CSS) are significantly correlated with 13 variables: age, marital status, race, grade, T stage, surgery, chemotherapy, bone metastatic, brain metastatic, liver metastatic, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2). These are included in the construction of the nomogram of OS and CSS. The time-dependent receiver operating characteristic curve, decision curve analysis, consistency index, and calibration curve prove the distinct advantages of the nomogram.

CONCLUSIONS

Our web-based dynamic nomogram effectively integrates patient molecular subtype and sociodemographic characteristics with clinical characteristics and guidance and can be easily used. ER-Negative should receive attention in diagnosing and treating BCLM.