Persistent Health Disparities Among Adult Cancer Survivors

ABSTRACT Cancer survivors face elevated risks of age‐ and treatment‐related health conditions, possibly due to accelerated biological aging from cancer therapy. The role of social determinants of health (SDOH) in these aging trajectories remains understudied. We conducted a retrospective cohort study of 109,224 curatively treated Danish cancer survivors (lung, breast, prostate, or colon cancer, diagnosed between 1997 and 2018) and 574,022 age‐ and sex‐matched cancer‐free individuals. SDOH was assessed using educational level and cohabitation status. Using national registries, we investigated associations between SDOH and 16 post‐cancer new morbidities with Cox proportional hazard models and flexible parametric models. During a median 6.9‐year follow‐up, cancer survivors had significantly higher rates of new morbidities than cancer‐free individuals. Lung cancer survivors had elevated hazard rates for 14 morbidities, breast cancer survivors had increased rates for 12 morbidities, prostate cancer survivors exhibited elevated rates for 8 morbidities, and colon cancer survivors had rates for 14 morbidities. Educational disparities were evident: survivors with short education had higher rates for chronic respiratory disease (HRs: 1.30–1.55 across cancer types), heart failure (HRs: 1.50–1.54 in breast and colon), diabetes (HRs: 1.67–1.95 in breast, prostate, and colon), and depression (HRs: 1.32–1.37 in breast and colon). Living alone was also associated with increased but less pronounced rates. Cancer survivors experience elevated rates for age‐ and treatment‐related post‐cancer new morbidities compared to cancer‐free individuals. Sociodemographic disadvantages, particularly short education, further increase these rates. These findings suggest that SDOH play an important role in post‐cancer aging, highlighting the need for targeted interventions addressing social determinants in survivorship care.