Abstract A019: Social risk factor burden among cancer survivors across adulthood: Insights from a descriptive analysis of national survey data

Abstract Background: As the population of cancer survivors continues to grow, there is increasing recognition that a cancer diagnosis may heighten vulnerability to social risks such as food housing, and transportation insecurity; however, nationally representative comparisons to adults without a history of cancer remain limited. This descriptive epidemiologic study estimated differences in individual-level social risk factors between U.S. cancer survivors and adults without a cancer history. Methods: We conducted a cross-sectional analysis using 2022–2023 Behavioral Risk Factor Surveillance System data. Social risks factors included insecurity related to food, housing, utilities, employment, and transportation; difficulty affording needed healthcare; and psychosocial challenges including life dissatisfaction, lack of social/emotional support, social isolation, and mental distress. We estimated unadjusted weighted prevalence and absolute differences (ADs, in percentage points) by cancer history to preserve interpretability and highlight meaningful population-level variation, consistent with descriptive epidemiology guidelines. Results were stratified by age group (18–39 [adolescents and young adults, AYA], 40–64, ≥65 years) to account for differences in cancer history and social conditions across adulthood. Among AYAs, further stratified analyses by Medicaid expansion status, sex, and race/ethnicity explored variation in social risks. Results: The analytic sample included 472,531 adults (weighted n=265.6 million); 8.7% were cancer survivors. Overall, 26.4% of cancer survivors and 34.9% of adults without a cancer history reported one or more social risks, though these differences varied substantially by age and demographic subgroups, justifying stratified analyses. In age-stratified analyses, AYA cancer survivors had higher prevalence of social risks than peers without a cancer history, including mental distress (AD: 11.2%), housing insecurity (AD: 9.4%), and food insecurity (AD: 7.2%), despite higher food assistance (SNAP) use. Differences were minimal among adults aged 40–64 and largely reversed among those aged ≥65; however, mental distress, social isolation, and life dissatisfaction remained elevated among survivors across all age groups. Among AYAs, ADs in food, housing, and utility insecurity between cancer survivors and those without a cancer history were larger in Medicaid non-expansion states. Male AYA survivors had greater ADs in social risks compared to males without a cancer history, while female survivors exhibited higher absolute prevalence of most risks. Racial/ethnic minority AYAs survivors had the highest overall prevalence of social risks. Conclusions: Social risk burden among cancer survivors varies by age and demographic factors, with AYA cancer survivors experiencing a particularly high burden influenced by Medicaid expansion status, sex, and race/ethnicity. These findings highlight the need for targeted, age- and context-specific interventions to address social risks and support survivorship care. Citation Format: Ami E. Sedani, Bijal A. Balasubramanian, Stephanie B. Wheeler, Anisha P. GangulyAmi E. Sedani, Bijal A. Balasubramanian, Stephanie B. Wheeler, Anisha P. Ganguly. Social risk factor burden among cancer survivors across adulthood: Insights from a descriptive analysis of national survey data [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A019.