Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Allostatic load and comorbidities in people with and without cancer: an analysis of the National Health and Nutrition Examination Surveys 2015-2023 (144480)

Huah Shin Ng 1 2 , Richard Woodman 1 , Katia Ferrar 1 , Ling Davies 3 , Liz Buckley 1 , Arduino A Mangoni 1 3 , Bogda Koczwara 1 4
  1. College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
  2. SA Pharmacy, Northern and Southern Adelaide Local Health Networks, Adelaide, SA, Australia
  3. Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, SA, Australia
  4. Australian Research Centre for Cancer Survivorship, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia

Introduction: Allostatic load (AL) refers to the cumulative burden of “wear and tear” across multiple body systems resulting from chronic stress. Higher AL has been associated with chronic conditions and inferior outcomes, but whether this relationship differs between people with and without cancer is unclear. This study examined the relationship between AL and patterns of comorbidities in people with and without cancer.

Methods: This cross-sectional study used data from adults participating in the National Health and Nutrition Examination Surveys 2015-2023. An AL score was constructed using twelve biomarkers representing immune, metabolic, and cardiovascular system functions. Latent class analysis (LCA) was used to identify patterns of comorbidities (including depression, diabetes, thyroid, cardiovascular, respiratory, arthritis, liver, and kidney diseases). Multivariable logistic models assessed the relationship between AL and patterns of comorbidities stratified by cancer status.

Results: A total of 15,553 people were analysed including 1774 (11%) with a history of cancer. LCA identified two comorbidity phenotypes–low and high comorbidity–in both the cancer and non-cancer groups. Higher AL (≥3 versus <3 scores) was associated with increased odds of high-comorbidity compared to low-comorbidity phenotypes in both cancer and non-cancer groups, and the magnitude of this association tended to be higher in the cancer group (2.29 versus 2.17). For individual comorbidity types, higher AL (≥3 versus <3 scores) was associated with increased odds of all eight comorbidities in the non-cancer group. Similar patterns were observed in the cancer group, although the associations did not reach statistical significance for thyroid disease and depression.

Conclusion: There was a positive association between AL and the presence of comorbidities, regardless of cancer status. However, the magnitude of the effect differed by comorbidity type. Further research is needed to elucidate the mechanisms underlying the interplay between AL and comorbidity in cancer to inform risk stratification and management strategies.