CANCER DISPARITIES IN PAIN AND HEALTH-RELATED QUALITY OF LIFE AMONG GASTROINTESTINAL CANCER SURVIVORS IN THE U.S.: WITH A FOCUS ON SOCIAL DETERMINANTS OF HEALTH (SDOH)

There are health disparities in cancer pain and health-related quality of life (HRQoL) among gastrointestinal (GI) cancer survivors. However, the factors contributing to these disparities are unknown. The purpose of this study is to examine the associations of pain and HRQoL with individual levels (...

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Bibliographic Details
Published in:Oncology nursing forum Vol. 51; no. 2; p. 334C
Main Authors: Han, Claire, Tounkara, Fode, Kalady, Mathew, Noonan, Ann, Paskett, Electra, Von Ah, Diane
Format: Journal Article
Language:English
Published: Pittsburgh Oncology Nursing Society 01-03-2024
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Summary:There are health disparities in cancer pain and health-related quality of life (HRQoL) among gastrointestinal (GI) cancer survivors. However, the factors contributing to these disparities are unknown. The purpose of this study is to examine the associations of pain and HRQoL with individual levels (e.g., age, race) and contextual levels (e.g., income, education, home ownership, health care access) of social determinants of health (SDOH). An increasing number of long-term GI cancer survivors often experience chronic pain, including abdominal/pelvic pain, neuropathy pain, and bodily pain, caused by cancer or cancer treatments. Chronic pain in GI cancer survivors has emerged as one of the most prevalent issues, reducing HRQoL. Understanding the social determinants of pain and HRQoL among GI cancer survivors is a vital aspect of cancer survivorship to identify their needs and optimize their care. Adult GI cancer survivors (n = 3,201) in the Behavioral Risk Factor Surveillance System (BRFSS) surveys from 2014-2021 were analyzed. Logistic regression was used to estimate the odds ratios (ORs), 95% confidence intervals (CIs) for the association of SDOH with pain and HRQoL in both unadjusted/adjusted models. We only included SDOH factors in the regression models if they were significantly associated with pain or HRQoL. Stepwise eliminations were performed in multivariate regression models to select a parsimonious model. In the adjusted models, non-Hispanic Blacks, health risk behaviors (sedentary lifestyles, smoking, and alcohol consumption), younger age < 65 years old, being diagnosed with liver or pancreatic cancers among GI cancer types, poor health care access, and more comorbidities were associated with higher pain and poor HRQoL. Healthy diet habit was not associated with pain or HRQoL. Among SDOH risk factors, lack of physical activity was the most significant risk factor for cancer pain (OR = 2.01, 95% CI: 1.81 to 2.41) and poor HRQoL (OR = 1.98, 95% CI: 1.71, 2.32). SDOH plays a critical role in cancer pain and HRQoL. Future studies are warranted to develop tailored community-based survivorship interventions such as physical rehabilitation, behavioral interventions, and social support, and to test a machine learning/artificial intelligence-based predictive model to identify GI cancer survivors at high risk of pain and poor HRQoL. Identifying risk factors of pain and HRQoL with a focus on SDOH is the first time research among GI cancer survivors.
ISSN:0190-535X
1538-0688