Associations of loneliness and mortality risk among cancer survivors in the United States.

6531Background: Loneliness (i.e., the subjective feeling of being isolated from others), has been linked to multiple adverse health outcomes, including chronic conditions such as heart disease, mental health disorders, and higher risk for early mortality. However, associations between loneliness and worse health outcomes have not been thoroughly examined in cancer survivors. This study examined associations between loneliness and mortality risk among cancer survivors in the U.S. Methods: Cancer survivors were identified from the 2008-2018 Health and Retirement Study, a nationally representative longitudinal survey conducted biannually among individuals aged ≥50 years, with follow-up was through December 31, 2020. Loneliness was measured at every 4 years using an abbreviated 11-item version of the UCLA Loneliness Scale Version 3. Example items include feelings of lacking companionship and isolation from others. Items were summed to create total loneliness scores, which were categorized into four levels: 11-12 (low/no loneliness), 13-15 (mild loneliness), 16-19 (moderate loneliness), and 20-33 (high loneliness). Time-varying Cox proportional hazard models were used to examine the association of loneliness and mortality risk among cancer survivors, while accounting for measurements at multiple time points. Sex, marital status, educational attainment, number of health conditions other than cancer, and year since cancer diagnosis were included in multivariable models. Results: Among 5808 person-years, there were 724 deaths during the study period. Compared to the low/no loneliness group, survivors reporting greater loneliness had higher hazard ratios (HR), indicating higher mortality risks; the highest HR observed was among the high loneliness group (HR:1.90, 95%CI:1.58-2.29), following a dose-response association (Table). HRs were attenuated after adjusting for sociodemographic characteristics, but findings were largely unchanged, and HRs remained highest for the high loneliness group (HR:1.71, 95%CI:1.39-2.12). Conclusions: Any elevated loneliness was associated with higher mortality risks among cancer survivors. Programs to screen for loneliness among cancer survivors and to provide social support to those in need are warranted. Association of loneliness and mortality risk among cancer survivors. Loneliness ScoreUnadjusted HR (95%CI)Adjusted HR (95%CI)11-121113-151.28 (1.00-1.63)1.21 (0.92-1.58)16-191.62 (1.33-1.98)1.47 (1.19-1.82)20-331.90 (1.58-2.29)1.71 (1.39-2.12)