ArticleJournal of cancer survivorship : research and practice2026
Post-traumatic stress disorder and social determinants of health among individuals with cancer: association with healthcare utilization and outcomes in the All of Us Research Program.
Article in Journal of cancer survivorship : research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIndividual effect of posttraumatic stress disorder (PTSD) and social determinants of health (SDoH) on healthcare utilization and well-being among cancer patients remains unclear. We sought to assess independent and combined effects of these factors on healthcare utilization and self-reported well-being.
methodsAll of Us Research Program was used to identify participants with cancer and/or PTSD, as well as individuals with neither. SDoH burden, healthcare utilization, and well-being were assessed relative to PTSD on multivariable logistic regression adjusting for sociodemographic factors.
resultsAmong 16,261 participants, 11.6% (n = 1895) had cancer, 1.4% (n = 228) had cancer and PTSD, and 20.1% (n = 3281) had PTSD alone. PTSD was associated with higher odds of emergency room visits (aOR 4.16, 95% CI 3.80-4.55), poor mental (aOR 3.77, 95% CI 3.43-4.14), and emotional health (aOR 3.76, 95% CI 3.41-4.16) (all p < 0.001). High SDoH burden independently predicted increased inpatient and emergency visits (aOR 1.24, 95% CI 1.13-1.36), as well as greater risk of poor quality of life (aOR 3.71, 95% CI 3.20-4.32) (all p < 0.001). Cancer patients with PTSD and high SDoH burden had substantially greater odds of poor mental health (aOR 10.92, 95% CI 9.33-12.77) and poor emotional health (aOR 12.20, 95% CI 10.33-14.41) (all p < 0.001).
conclusionCancer, PTSD, and high SDoH burden were independently associated with greater healthcare use and worse well-being with combined exposures amplifying risk among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Survivors with PTSD and high SDoH burden are especially vulnerable. Integrating trauma-informed care and SDoH screening strengthens survivorship equity and outcome.
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