Psychosocial Risk Factors and Perceived Well-Being in Survivors of Gastrointestinal Cancer.

Background: There are 18 million cancer survivors in the United States; 10% have gastrointestinal (GI) cancer. Psychosocial risk factors (PSRF) and perceived health (PH) are important to their well-being.

Aims: This study examines PSRF among survivors of GI cancer and evaluates their association with PH.

Methods: A cross-sectional analysis of the All of Us Research Program included survivors of GI cancer who completed Social Determinants of Health and Overall Health surveys. PSRF were assessed using validated scales. Regression models evaluated associations between PSRF and PH.

Results: 13,813 patients with GI cancer were included. Female patients were more likely to perceive good physical health (OR 1.52 [95% CI: 1.30-1.79]) than male patients. Black patients reported higher discrimination (β 0.25 [95% CI: 0.20-0.31]) compared to white patients. Increased loneliness and stress decreased the odds of reporting good mental health by 53% (OR 0.47 [95% CI: 0.39-0.56]) and 39% (OR 0.61 [95% CI: 0.50-0.74]), respectively. Increased spirituality was associated with improved perceived mental health (OR 1.12 [95% CI: 1.06-1.17]). Healthcare discrimination (OR 0.87 [95% CI: 0.79-0.97]) and loneliness (OR 0.84 [95% CI: 0.73-0.97]) were negatively associated with perceived physical health. Social support (OR 1.16 [95% CI: 1.06-1.26]) and spirituality (OR 1.08 [95% CI: 1.02-1.14]) were positively associated with quality of life.

Conclusion: Protective PSRF such as social support and spirituality are correlated with better perceived health in survivors of GI cancer. Tailoring supportive services based on patient-reported experience may help improve quality of life in cancer survivorship.