Characterizing Social Determinants of Health in GI Cancer Surgery: Insights From the All of Us Research Program

Social Determinants of Health (SDoH) are increasingly recognized as critical contributors to cancer outcomes. Understanding SDoH among patients undergoing cancer surgery may reveal disparities that influence care and recovery. This study assessed the prevalence and variation of SDoH among patients undergoing gastrointestinal (GI) cancer surgery using a national dataset.

We conducted a cross-sectional analysis using the National Institutes of Health All of Us Research Program. Adults with GI cancer were identified using diagnosis codes, and surgery was confirmed using procedure codes. Participants who completed the SDoH survey were included. Descriptive statistics summarize demographics and SDoH domains: economic stability, healthcare access, neighborhood environment, and social context.

Of 6620 participants with GI cancer, 1747 underwent surgery; 470 (26.9%) completed the SDoH survey. Mean age was 69.4 years; 82.1% were White and 61.3% had college degrees. Most had health insurance (96.6%) and stable housing (88.7%), though 25.5% reported poor housing quality and 7.6% reported food insecurity. PROMIS T-scores for physical and mental health were below average at 37.0 and 38.4, respectively.

Despite favorable SDoH profiles, GI cancer surgery patients reported below average physical and mental health. These findings highlight the need to integrate multidomain SDoH data in cancer care research.