Abstract B138: Obesity-related cancer survivorship in Puerto Rico: Exploring lifestyle behaviors, comorbidities, and health-related quality of life

Abstract Introduction: Obesity is widely recognized as a risk factor for 13 cancers, including postmenopausal breast, colorectal, endometrial, esophageal adenocarcinoma, gallbladder, kidney, liver, ovarian, pancreatic, stomach, thyroid, multiple myeloma, and meningioma. It is associated with poor lifestyle behaviors, comorbidities, and reduced health-related quality of life (HRQoL) during survivorship. Despite the elevated obesity prevalence among adults in Puerto Rico (37%), limited research has assessed differences in lifestyle behaviors, comorbidities, and HrQoL between survivors of obesity-related cancers (ORCs) and non-ORCs. This study examines these differences among cancer survivors in Puerto Rico. Methods: This cross-sectional study included 491 cancer survivors from the Impact of Social Determinants of Health on the Cancer Care Continuum in Cancer Survivors in Puerto Rico (START-PR). Eligible participants were cancer survivors aged ≥ 21 years who were undergoing active treatment on the island. ORC status was defined based on the primary tumor site and categorized among the 13 cancers known to be associated with obesity; all other cancer types were classified as non-ORCs. The analysis focused on self-reported lifestyle behaviors (physical activity, smoking, and alcohol use—all coded as yes/no), number of comorbidities, and HRQoL, measured using the Functional Assessment of Cancer Therapy–General (FACT-G). Separate Poisson regression models with robust standard errors were used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the association between ORC status and lifestyle, comorbidities, and HRQoL, adjusting for sex, cancer stage, income, and age at diagnosis. Results: Compared to non-ORC survivors, those with ORCs were significantly older at the time of diagnosis (59.1±13.1 vs. 55.1±14.7) and more likely to be female (81% vs. 59%). In multivariable regression models, ORC survivors had a higher prevalence of smoking compared to non-ORC survivors (PR: 1.47, 95% CI: 1.05–2.06). However, there were no significant differences in physical activity, alcohol use, number of comorbidities, or HRQoL. In sex-stratified models, the associations between ORC status and alcohol use were not statistically significant in either women (PR: 1.25; 95% CI: 0.77–2.01) or men (PR: 0.41; 95% CI: 0.15–1.11); however, the interaction by sex was statistically significant (p-interaction <0.05), suggesting a differential pattern. Conclusion: Findings indicate a greater burden of smoking among ORC survivors, especially women, and suggest sex-specific patterns in alcohol use. Given Puerto Rico’s elevated obesity prevalence, further research should explore links between lifestyle factors, comorbidities, and low HRQoL in ORC survivorship. Culturally tailored public health efforts are needed to address obesity-related risks and support cancer survivors' HRQoL. Citation Format: William Hernandez, Marievelisse Soto-Salgado, Lorena González-Sepúlveda, Génesis Rodríguez-Ortiz, Cynthia M. Pérez, Carola T. Sánchez-Díaz. Obesity-related cancer survivorship in Puerto Rico: Exploring lifestyle behaviors, comorbidities, and health-related quality of life [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 B138.