Long-term association of cardiometabolic multimorbidity with physical pain among cancer survivors in China: a 10-year prospective cohort study

Background: In China, cancer accounts for one-fifth of all deaths, and exerts a heavy toll on patients, families, and society as a whole. Cardiometabolic multimorbidity (the presence of two or more cardiovascular and/or metabolic conditions) is a significant contributor to inequalities in health care and has become the major unaddressed challenge for the health system. This study aims to examine the socio-demographic and rural-urban differences in distribution of multimorbidity among patients with cancer in China. We also investigate the relationships between cardiometabolic multimorbidity on physical pain in cancer survivors. Methods: We conducted longitudinal analyses using 10-year data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020, identifying 847 cancer survivors aged ≥45 years. Chi-square tests were used to assess the significance of differences in cardiometabolic multimorbidity across socio-demographic groups. Ordinary logistic models were performed to examine the relationship between cardiometabolic multimorbidity and risk of body pain. Findings: Overall, 21.84% of 847 cancer survivors had cardiometabolic multimorbidity in China. Physical pains were found among 53.36% of cancer patients, with a higher proportion in females (58.82%) than males (37.93%). Cardiometabolic multimorbidity was associated with a higher likelihood of experiencing body pain [adjusted Odds Ratio (aOR)=1.660, 95% CI=1.158, 2.380]. The impact of multimorbidity on pain in male patients (OR=2.005, 95% CI=1.053, 3.820) and individuals living in the rural area (OR=2.034, 95% CI=1.257, 3.291) is higher than in females (OR=1.570, 95% CI=1.006, 2.451) and those patients living in the urban area (OR= 1.228, 95% CI=1.012, 1.465). Interpretation: Multimorbidity is associated with higher levels of health service use and a greater financial burden of individuals in China. Cardiometabolic multimorbidity and physical pain are common among cancer survivors in China, and multimorbidity is significantly associated with body pain. Our findings have implications for practitioners on the early assessment of multimorbidity after suffering from cancers. Future research should explore effective intervention measures for physical-mental complications, particularly cancer patients in rural areas. Funding: None.