273: Social Vulnerability, Disordered Eating and Pain Interference in Young Adult Cancer Survivors

Topic: Clinical Science
Subtopic: Non-specific to any diagnosis, Pain in Special Populations

Background and Aims: Pain is a common and burdensome symptom among cancer survivors, often limiting daily functioning and quality of life. In young adult (YA) survivors, pain is influenced by complex biopsychosocial factors, including sociodemographic characteristics, disease and treatment related factors, psychological distress, and comorbidities such as chronic illness, fatigue, depression, and anxiety. However, the influence of social and behavioral determinants such as neighborhood deprivation, food insecurity, and health behaviors on pain interference in YA survivors remains insufficiently understood. Addressing this gap is essential for developing targeted prevention and intervention strategies that reduce pain burden and improve survivorship outcomes in this population.

Methods: Cross-sectional analysis of data from 304 YA cancer survivors aged 18–24 years. Participants completed a sociodemographic survey; the Eating Attitudes Test‑26 (EAT‑26; ≥20 = eating pathology), the Binge Eating Scale (BES; ≥17 = binge eating), and the 2‑item Hunger Vital Sign (≥1 = food insecurity); a Physical Activity Screener; and items assessing vaping and marijuana use. Pain was measured using the Pain Interference T-score from the 29-item patient-reported outcome tool (PROMIS-29). In hierarchical regression models, pain interference served as the dependent variable. Variables were entered in three blocks: (1) demographics, (2) food insecurity, and (3) behavioral and clinical factors.

Results: Among 304 YA survivors (Mage=21.2±2.2 years; 52.6% female; 71.1% White; 11.5% Hispanic), mean ADI was 61.6±25.7, and 51% had at least some college education. Mean pain interference T-score was 47.5±8.8. Across the hierarchical models, explained variance increased from 5.0% in Model1 (R²=0.050, p=0.028) to 11.0% in Model2 (R²=0.110, p<0.001; ΔR²=0.060), and to 16.9% in Model 3 (R²=0.169, p<0.001; ΔR²=0.059; total ΔR²=0.119). In the final model, greater neighborhood deprivation (β=0.128, p=0.043), food insecurity (β=0.217, p<0.001), and higher disordered eating (EAT-26; β=0.212, p=0.002) were associated with higher pain interference.

Conclusions: Social disadvantage and disordered eating emerged as key correlates of pain interference among YA survivors, underscoring the broader public health importance of addressing upstream determinants of symptom burden. Disordered eating may be linked to pain interference through shared underlying pathways, including chronic stress, nutritional inadequacies, and inflammatory processes, especially in low-resource environments. Additionally, disordered eating may function as a maladaptive coping response to pain-related distress. These conditions may exacerbate pain and hinder functional recovery after cancer treatment. Targeted interventions that address food insecurity, enhance supportive services, and promote equitable survivorship resources may reduce pain‑related functional limitations and long‑term inequities

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Presenting Author: Marilyn Stern
Submitting Author: Ana Paula S. Rodrigues

Senior Author: Marilyn Stern

IASP 2026 Global Year theme of Neuropathic Pain: No

• Ana Paula S. Rodrigues: PhD - University of South Florida
• Acadia Buro: PhD - University of New Mexico
• Blaine Peters: BS - St. Jude Children's Research Hospital
• Niki Jurbergs: PhD - St. Jude Children's Research Hospital
• Anna M. Jones: PhD - St. Jude Children's Research Hospital
• Tara M. Brinkman: PhD - St. Jude Children's Research Hospital
• Rachel Webster: PhD - St. Jude Children's Research Hospital
• Marilyn Stern: PhD - University of South Florida, Moffitt Cancer Center