This study examined how aging-related deficit burden relates to cancer-specific outcomes in men diagnosed at markedly different developmental periods and with different cancer experiences. A modified Deficit Accumulation Index (DAI), a multi-system measure of aging based on proportional health deficits, was computed in two cohorts. Study 1 used cross-sectional data from 171 young adult testicular cancer survivors (ages 18–29). Study 2 used longitudinal data from 114 men with localized prostate cancer (ages 51–81) assessed before treatment and six months post-treatment. In Study 1, DAI scores ranged from 0 to .73 (M=.23), with 47.7% of young adult participants exhibiting medium or high deficit burden. Higher DAI was associated with greater job problems, family disruption, sexual problems, and treatment side effects after adjusting for age and time since diagnosis (p’s<.001). In Study 2, DAI scores ranged from 0 to .55 (M=.18), with 34.0% exhibiting medium or high deficit burden. Baseline DAI predicted worsening in hormonal functioning six months after treatment. Greater DAI was also associated with higher circulating interleukin-6 prior to treatment (p<.01). Across both cohorts, deficit accumulation functioned as a marker of survivorship burden; however, the specific outcomes associated with higher deficit burden differed across cohorts. Findings demonstrate the utility of the DAI as a multi-system metric for understanding vulnerability in cancer survivorship. • Deficit accumulation (DAI) associated with survivorship burden in cancer survivors. • In testicular cancer, DAI was linked to psychosocial and functional disruptions. • In prostate cancer, DAI predicted worse hormonal functioning and elevated IL-6. • DAI has promise as a multi-system indicator of vulnerability across cancers.
Hoyt et al. (2026) studied this question.