Subjective cognitive decline among U.S. Cancer survivors, 2017-2024: Prevalence, cancer-specific patterns, and...

To investigate the prevalence and cancer-specific patterns of subjective cognitive decline (SCD) among U.S. cancer survivors and its associated risk factors.

Data were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) 2017-2024, including 34,222 cancer survivors and 477,988 adults without a history of cancer. SCD was defined as self-reported confusion or memory loss. Multivariable logistic regression models were used to evaluate associations between SCD and sociodemographic, lifestyle, health-related, and survivorship factors. All analyses accounted for survey weights.

The prevalence of SCD was higher among cancer survivors (16.0%) than among adults without a history of cancer (13.1%). After adjustment for potential confounders, cancer survivors had higher odds of reporting SCD compared with non-cancer adults (adjusted OR = 1.27, 95% CI = 1.20-1.35). Within cancer survivors, higher odds of SCD were observed among those with three or more cancer diagnoses compared with those with a single diagnosis, and among those reporting cancer-related pain compared with those without pain. Higher odds of SCD were also observed among unaccompanied individuals, smokers, physically inactive individuals, and those with depression. Patterns of SCD varied across cancer types.

Approximately one in six U.S. cancer survivors reported SCD. Factors associated with SCD included cancer type, being unaccompanied, unhealthy lifestyle behaviors, depression, multiple cancer diagnoses, and cancer-related pain. These findings suggest that SCD reflects increased vulnerability among cancer survivors, highlighting the need for clinical attention.