Abstract A088: Examining associations between objective and perceived stress and allostatic load in African American prostate cancer survivors
Authors: Awoyinka Iwalola , Kilari Deepak , Bylow Kathryn , Knight Jennifer , Visotcky Alexis , Banerjee Anjishnu , Sheean Patricia , Papanek Paula , Stolley Melinda 
Published: September 2024

Background. Racial disparities in prostate cancer survivorship persist despite clinical advancements. Stress has been implicated as a potential driver of these disparities, with both chronic and perceived stress found to be associated with adverse cancer survivorship. Allostatic load (AL), one such marker of chronic stress, has been associated with decreased survivorship and worse quality of life (QoL) in cancer survivors. Perceived stress has also been associated with outcomes in cancer survivorship including increased symptom burden and worse quality of life. Despite this, few studies incorporate direct measures of stress or examine how these measures contribute to AL This study examines the relationship between AL, objective stress (as measured by occurrence of stressful life events), and self-reported perceived stress in a subset of African American prostate cancer survivors (N=59) enrolled in Men Moving Forward, a randomized trial to improve body composition through lifestyle change. Methods. At baseline, participants completed an adapted version of the Crisis in the Family Systems (CRISYS) survey, an instrument designed to measure recent (past 4 months) contemporary life stressors. The survey was tailored for AAPCS via feedback from the community advisory board. 41 items reflective of 11 domains were included. Overall CRISYS scores and scores by domain were calculated. Feelings of perceived stress in the past month were measured via the 10-item perceived stress scale, with higher scores reflecting higher perceived stress. AL scores used 15 criterion reflecting neuroendocrine, cardiovascular, immune, and metabolic systems. Each criterion was assigned a score of 0 or 1: 1 if in the high-risk range based on clinical guidelines. An index score was generated by summing high-risk indicators. Pearson correlations were used to explore the relationship between stress measures. Logistic regression comparing the those with highest quartile AL to lower AL was also performed. Results. The mean AL score was 5.6 (SD ± 2.4) of a maximum score of 15. The mean summative score for CRISYS was 4.8 (SD ± 3.3). The most common domains of stress experienced were safety in the community (67%), relationships (66%), and medical issues of loved ones (44%). The Mean PSS was 11.5 (SD ± 6.0), with 64% of men reporting low stress and 36% moderate stress levels. Significant correlations were found between CRISYS and PSS, however no correlations with AL were detected. No significant findings were identified in the regression analysis. Conclusions. Objective and perceived stress measures were correlated, but no associations were found between the perceived or objective stress measure and AL in this sample.. Given AL is meant to reflect the physiological impact of cumulative and chronic stress burdens, it is possible that the shorter-term context of the objective (past 4 months) and perceived stress (past month) measures were not sufficiently aligned with the longer-term context of AL.

Citation Format: Iwalola Awoyinka, Deepak Kilari, Kathryn Bylow, Jennifer Knight, Alexis Visotcky, Anjishnu Banerjee, Patricia Sheean, Paula Papanek, Melinda Stolley. Examining associations between objective and perceived stress and allostatic load in African American prostate cancer survivors [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A088.