Abstract C126: Exploring racial disparities on the association between allostatic load and cancer mortality: A retrospective cohort analysis of NHANES, 1988 through 2015

Abstract Background: Several studies suggest that chronic stress may be associated with increased risk of cancer mortality. Our study sought to determine the association between allostatic load (AL), a measure of cumulative stress, and risk of cancer death; and whether these associations varied by race/ethnicity and age. Methods: We performed retrospective analysis using National Health and Nutrition Examination Survey (NHANES) years 1988 through 2010 linked with the National Death Index through December 31, 2015. We fit Fine & Gray Cox proportional hazards models to estimate sub-distribution hazard rates (sHRs) of cancer death between high and low AL status (adjusted for age, sociodemographics, and comorbidities). Results: In fully adjusted models, high AL was associated with a 23% increased risk of cancer death (adjusted (sHR): 1.23, 95% CI: 1.10-1.38) among all participants and a 24% increased risk of cancer death (sHR :1.24, 95% CI: 1.07-1.44) among Non-Hispanic Whites (NH-White). When further stratified by age (participants aged <40 years), high AL was associated with a 74% increased risk (sHR: 1.74, 95% CI: 1.28 – 2.37) among all participants; a 2-fold increased risk (sHR: 2.02, 95% CI: 1.05 – 3.87) among NH-Whites; an 88% (sHR: 1.88, 95% CI: 1.09 – 3.23) increased risk among Non-Hispanic Blacks (NH-Black); and a 48% increased risk among Hispanics (sHR: 1.48, 95% CI: 0.89 – 2.45). Conclusions: Overall, when stratified by race, the risk of death attributed to cancer remained significant, however among NH-Blacks and Hispanics this association was slightly attenuated. Impact: High AL is associated with increased risk of overall cancer death, and future studies should delineate the association between AL and cancer-specific mortality to better understand the causal mechanisms between cumulative stress and cancer. Citation Format: Sydney E. Andrzejak, Justin X. Moore, Malcom Bevel, Samantha R. Jones, Martha S. Tingen. Exploring racial disparities on the association between allostatic load and cancer mortality: A retrospective cohort analysis of NHANES, 1988 through 2015 [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C126.