Abstract C112: The association between heart disease and health-related quality of life among cancer survivors in Puerto Rico
Abstract
Cardiovascular disease (CVD) is a common comorbidity among cancer survivors and is associated with poorer health-related quality of life (HRQoL). Yet knowledge gaps remain regarding Puerto Rican cancer survivors, a population disproportionately affected by cancer and cardiovascular health disparities. This study evaluated the association between heart disease and HRQoL among participants in the Impact of Social Determinants of Health on the Cancer Continuum in Cancer Survivors in Puerto Rico (START-PR) study. Cross-sectional data from 755 participants aged ≥ 21 enrolled between November 2023 and August 2025 who completed the Functional Assessment of Cancer Therapy-General (FACT-G) survey were analyzed. Bivariate analyses evaluated differences in FACT-G scores by participant characteristics. Multivariable logistic and linear regression models estimated adjusted prevalence ratios (PRs) and β coefficients for the association between heart disease and HRQoL. Covariates included age, sex, marital status, education, residential area, insurance status, depression, physical activity, smoking, alcohol use, cancer type, stage, time since diagnosis, and treatment status. Overall FACT-G scores were lower among participants with heart disease than those without (60.8 ± 5.7 versus 70.0 ± 19.6; p < 0.001). Younger participants, those with lower educational attainment, and those diagnosed with advanced cancer stages reported lower mean HRQoL. After adjustment, heart disease remained significantly associated with low overall HRQoL (PR=1.35, 95% CI: 1.10–1.65), as well as lower functional, physical, and social well-being. Consistent with these findings, linear regression models showed that heart disease was associated with a 9-point reduction in overall HRQoL (β=-9.00, 95% CI: -13.75, -4.25), with significant declines in functional (β=-2.80, 95% CI: -3.78, -1.82) and social (β=-2.17, 95% CI: -3.15, -1.19) well-being. Heart disease was independently associated with poorer HRQoL among Puerto Rican cancer survivors, particularly in the functional and social well-being domains. Given Puerto Rico's high, modifiable CVD burden, these findings underscore the importance of integrating CVD risk assessment and management into survivorship care. Addressing cardiovascular comorbidities may improve quality of life and help reduce persistent health disparities among Puerto Rican cancer survivors. Richard J. Holcknecht, Génesis Rodríguez-Ortiz, Lorena Gonzáles Sepulveda, Marivelisse Soto-Salgado, Carola T. Sánchez-Díaz. The association between heart disease and health-related quality of life among cancer survivors in Puerto Rico [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr C112.