Abstract 2252: Loneliness, quality of life, and physical and mental health among cancer patients: All of US research program
Authors: Lee Hyunjung , Ng Ding Quan , Lee Dongjun , Jemal Ahmedin , Islami Farhad 
Published: March 2024

Background: Loneliness, as a distressing feeling, occurs with a discrepancy between an individual’s social needs and one’s social relationship. Cancer patients, particularly, may feel loneliness, when their expected practical and emotional support from family or friend were not met. Loneliness can impair the capacity to self-regulate lifestyle behaviors and induce systemic inflammation through dysregulation of autonomic nervous system and the hypothalamic-pituitary-adrenal axis. While a growing body of literature has found an association between loneliness and physical or mental health, quality of life, morbidity or mortality, few studies have examined this association among cancer patients and effects of loneliness by sociodemographic characteristics.

Method: We used All of US Controlled Tier Dataset v7 (summer 2017-July 1, 2022) which comprised survey and electronic health records data. Study sample included cancer patients aged ≥18 years (N=17,367). Loneliness was measured using the University of California, Los Angeles (UCLA)-3 items loneliness scale, which includes relational connectedness, social connectedness, and self-perceived isolation. Logistic regression models were used to estimate the association between loneliness and self-reported pain, fatigue, fair/poor health physical and mental health status, and quality of life, controlling for various covariates. We stratified the models by age, sex, race/ethnicity, income, education, living arrangement, and marital status.

Results: Lonely cancer patients were more likely to have fair or poor quality of life (OR=3.80; 95% CI=3.33-4.34), severe pain (OR=1.55; 95% CI=1.35-1.79), severe or very severe fatigue (OR=2.41; 95% CI=2.07-2.80), fair or poor physical health (OR=2.26; 95% CI=2.05-2.50), and fair or poor mental health (OR=4.22; 95% CI=3.72-4.80) compared to non-lonely cancer patients, controlling for all other covariates. All stratified models generally showed similar results. However, the association between loneliness and severe pain was stronger in the younger group, whereas the association with mental health was stronger in the older group. The effect of loneliness on mental health was stronger among males (OR=5.42; 95% CI=4.30-6.83) than females (OR=3.84; 95% CI=3.29-4.49; p for difference &lt; 0.05). By living arrangements, the relationship between loneliness and severe fatigue was stronger among cancer patients living alone (OR=3.15; 95% CI=2.33-4.25) than those living with others (OR=2.16; 95% CI=1.81-2.59; p for difference &lt; 0.05).

Conclusions: In this study, lonely cancer patients were more likely to have poor quality of life, poor mental and physical health, and severe pain and fatigue compared to non-lonely patients. These findings underscore the significance of policy and clinical interventions to alleviate negative effect of loneliness on health outcomes among cancer patients.

Citation Format: Hyunjung Lee, Ding Quan Ng, Dongjun Lee, Ahmedin Jemal, Farhad Islami. Loneliness, quality of life, and physical and mental health among cancer patients: All of US research program [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2252.