Abstract B097: Differences in health-related social needs between younger and older cancer survivors in a United States representative sample, 2016-2018
Authors: Castillo Wendy Camelo , Damachi Udim , Tran Phuong , Cheung Christabel K. , Villalonga-Olives Ester , Onukwugha Eberechukwu 
Published: January 2023

Abstract
Background: Health-Related Social Needs (HRSN) are unmet person-level social and economic challenges, such as food and housing insecurity, that potentially impact health outcomes. Evidence of HRSN burden in cancer survivors is limited and differences across age groups largely unexplored. Our goal is to estimate the prevalence of HRSN among cancer survivors across age groups and explore associated factors in a nationally representative sample. Methods: A cross-sectional cohort of cancer survivors, 18 years and older, was identified from the National Health Interview Survey (NHIS), 2016-2018. Survivorship (i.e., time since cancer diagnosis) was assessed at the time of the survey. Key needs for cancer survivors (food insecurity, transportation needs, inability to pay for utilities, inability to pay for housing, and inability to pay for healthcare needs) were used in this analysis. Individuals report their current experience with needs at the time of the survey. Prevalence rates were estimated as the proportion of cancer survivors with a given need within each of the five key needs. A measure of HRSN was developed to indicate whether an individual experienced at least one or more HRSN (any HRSN). Multivariable logistic regression was used to explore the association between having any HRSN and current age (young [YA], 18-39y; middle age [MA], 40-64y; older adult [OA], &gt;=65 y), key sociodemographic characteristics, age at cancer diagnosis, and survivorship. All estimates, including Odds Ratios (OR) and 95% confidence intervals (CI), were weighted to represent the US census-based population. Results: We identified 7,179 cancer survivors, 44.9% under 65 years old, 59.1% female, 85.9% White. Overall, 44.8% reported experiencing any HRSN at any time during survivorship, with 21.4% experiencing any HRSN in their first two years after cancer diagnosis. Inability to pay for utilities was the most prevalent need, with differences across age groups (40.7% YA, 33.4% MA, 17.2% OA). Higher inability to pay for housing was reported among YA (28.64%) than MA (25.9%) or OA (11.9%). There were no differences in reported food insecurity across age groups (YA 16.2%, MA 16.5%, OA 16.5%). When compared to OA, YA (OR 1.77, CI 1.24-2.60) and MA (OR 1.74, CI 1.49-2.01) had higher odds of having any HRSN. Key factors associated with higher odds of any HRSN include being non-White (OR 1.42, CI 1.16-1.74), Hispanic (OR 1.46, CI 1.08-1.98), female (OR 1.31, CI 1.14-1.51), or being diagnosed with cancer during childhood (OR 1.62, CI 1.04-2.52) or young adulthood (OR 1.65, CI 1.29-2.23). Conclusion: HRSN are prevalent throughout cancer survivorship. Our findings show that young and middle age are more likely than older adults to experience HRSN at any point during survivorship. Further exploration of pathways leading to unmet needs is needed to address inequalities and improve survivorship care across age groups.
Citation Format: Wendy Camelo Castillo, Udim Damachi, Phuong Tran, Christabel K. Cheung, Ester Villalonga-Olives, Eberechukwu Onukwugha. Differences in health-related social needs between younger and older cancer survivors in a United States representative sample, 2016-2018 [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B097.