Cancer history and accelerated aging: findings from a nationally representative sample in the US.

Purpose: Cancer and its treatments may accelerate the aging process. However, accelerated aging among cancer survivors is not well understood. This study examines accelerated aging among adults with and without a cancer history in a nationally representative sample and identifies health-related social needs and behavioral factors associated with accelerated aging.

Methods: We conducted a cross-sectional study of 11,432 adults aged 20-84 years from the 1999 to 2010 National Health and Nutrition Examination Survey, including 728 cancer survivors. Accelerated aging was measured by validated Phenotypic Age Acceleration (PhenoAgeAccel) based on clinical chemistry biomarkers. We described accelerated aging by cancer history, demographics, health-related social needs, and health behaviors, and utilized weighted linear regression to assess their associations with accelerated aging.

Results: Majority of the sample were < 65 years old (n = 8,800, weighted percentage = 84.8%), female (n = 5,856, 50.8%), and non-Hispanic White (n = 5,709, 71.7%). Cancer survivors experienced an average of 0.14 (95% CI 0.03, 0.24) years of accelerated aging measured by PhenoAgeAccel. Individuals who were male, unmarried, less educated, with lower-income, or with 3 or more medical conditions also had accelerated aging regardless of cancer history. Moreover, health-related social needs in food insecurity, unemployment, health insurance and coverage continuity as well as obesity and smoking were associated with accelerated aging in both cancer survivors and individuals without a cancer history.

Conclusions:  Cancer survivors experience accelerated aging in the US. Addressing health-related social needs and promoting healthy behaviors in care delivery may advance healthy aging.