In a publication in the Journal of the National Comprehensive Cancer Network, researchers presented findings from a nationally representative longitudinal panel survey exploring the correlation between loneliness and risk of mortality among cancer survivors in the United States.

The authors wrote, “Loneliness, a subjective feeling of being isolated, is a prevalent concern for elderly people and more so among cancer survivors because a cancer diagnosis and its subsequent treatment may result in long-term adverse health effects.”

For this survey, researchers reviewed and gathered data from the 2008–2018 Health and Retirement Study (HRS), which is conducted biennially. The survey involved cancer survivors who were aged 50 years or older. The participants were asked questions about health, employment status, and psychosocial well-being. Each participant was surveyed multiple times, and loneliness and other time-varying variables were measured frequently throughout the years. Follow-up for vital status was acquired through December 31, 2020.

To measure loneliness, researchers employed an 11-item abbreviated version of the University of California, Los Angeles (UCLA) Loneliness Scale (Version 3), which included questions about lacking companionship and feeling isolated from others. The response options were noted as “often,” “some of the time,” and “hardly ever or never.”

Established on patient response to each question, the researchers assigned a score, with 1 noted for the least lonely, 2 for moderately lonely, and 3 for the loneliest option. Based on the sample distribution, the items were then tallied to generate total loneliness scores for each individual, which were classified into four levels:

• Level 1: 11-12 (low/no loneliness)
• Level 2: 13-15 (mild loneliness)
• Level 3: 16-19 (moderate loneliness)
• Level 4: 20-33 (severe loneliness).

The researchers utilized time-varying Cox proportional hazard models with age as a time scale after validating proportional hazards with log-log Kaplan-Meier curves to investigate the correlation between loneliness and survival among cancer survivors.

The survey included 3,447 cancer survivors with 5,711 person-years of observation. The results revealed that 24.3% of participants reported low-to-no loneliness, 24.5% reported mild loneliness, 23.6% reported moderate loneliness, and 27.6% reported severe loneliness. During the study period, 686 deaths were reported among the study cohort, and a higher degree of loneliness was correlated with worse survival among cancer survivors.

The authors wrote, “In adjusted analysis (weighted), compared with the low/no loneliness group, survivors with higher loneliness scores had higher mortality risk, with the highest adjusted hazard ratio (aHR) observed among the group with severe loneliness (aHR, 1.19 [95% CI, 0.86-1.63] for mild loneliness; 1.41 [95% CI, 1.01-1.96] for moderate loneliness; and 1.67 [95% CI, 1.25-2.23] for severe loneliness), following a dose-response association (P = .004).”

The authors noted that their findings expand the mounting body of research connecting loneliness to vital health outcomes, including morbidity and mortality, in the context of cancer. The findings also suggested that screening patients for loneliness should be an integral part of survivorship care and of concern to primary care and cancer clinicians due to the potential adverse associations of loneliness and mortality risk.

The authors concluded, “Elevated loneliness was associated with a higher mortality risk among cancer survivors. Programs to screen for loneliness among cancer survivors and to provide resources and support are warranted, especially considering the widespread social distancing that occurred during the COVID-19 pandemic.”

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.