Health outcomes in cancer survivors living alone vs. living with family: a multinational survey study

With an increasing number of individuals living alone, it is important to understand its impact on health outcomes in cancer survivors. However, previous studies have not sufficiently considered variations in age, sex, and survival period, even though these are important effect modifiers. This study aims to determine whether cancer survivors living alone have worse general and mental health outcomes compared to those living with family. A multinational cross-sectional study used data from the US National Health and Nutrition Examination Survey (NHANES) and Korean NHANES (KNHANES) from 2007 to 2021, including 6,400 cancer survivors (1,198 living alone and 5,202 living with family). The primary outcomes were general health status and mental health (limitations on daily activities due to emotional problems and suicidal ideation). Cancer survivors living alone had higher odds for poor/fair general health than survivors living with family (aOR, 1.34; 95% CI, 1.14–1.56). Regarding health behaviors, those living alone were slightly more likely to be current smokers and to have comorbidities. Furthermore, those living alone had significantly higher odds of limitations on daily activities due to emotional problems (aOR, 3.99; 95% CI, 1.49–10.68) and suicidal ideation (aOR, 1.45; 95% CI, 1.03–2.05) than those living with family. The association was strongest in those younger than 40 years (P for interaction = 0.01) and in survivors diagnosed within 1 year (P for interaction < 0.01). Cancer survivors living alone experience significantly worse general and mental health outcomes, particularly younger survivors and those in the early post-diagnosis period, suggesting the need for further longitudinal research to clarify the underlying mechanisms.