Food insecurity linked to elevated mortality risk among cancer survivors 

Philadelphia, PA — Lack of access to healthy food is a threat to the lives of cancer survivors—a significant and often overlooked factor affecting their long-term health outcomes. A new study shows that those experiencing food insecurity had a 28 percent relative increase in risk of death as compared to those who were food secure.   

In the study, published recently in JAMA Health Forum, researchers from the University of Pennsylvania Perelman School of Medicine analyzed data from more than 5,000 respondents who shared their cancer diagnoses as part of a nationwide, government-sponsored health survey.  

“Food matters in cancer care and outcomes,” said study senior author Jaya Aysola MD, MPH, Associate Professor of Medicine and executive director of the Centers for Health Equity Advancement at Penn Medicine. “The results show that simple, integrated solutions can help prolong the lives of cancer survivors by helping put healthy food on their table.” 

Addressing root causes 

Food insecurity, estimated to affect about 40 million people in the US alone, is the condition in which good nutrition is of limited or uncertain availability. It is considered a significant socioeconomic factor in overall health and has been linked to higher risks of chronic diseases including heart disease, diabetes, some mental health disorders, hypertension, kidney disease, and colorectal cancer. 

The investigators made use of data from the US Centers for Disease Control and Prevention’s 2011 and 2012 National Health Interview Surveys (NHIS), as well as the U.S. National Death Index through 2019. Their analysis covered a total of 5,603 adults 40 and older who reported having had a cancer diagnosis on the NHIS and answered its questions relating to food security. 

A total of 579 (10.3%) of the respondents reported food insecurity. This group had higher all-cause mortality—overall risk of death—through 2019, compared to cancer survivors who did not report food insecurity. After adjustment for potentially relevant differences between respondents, such as sex, age, smoking status, and the presence of other illnesses, there remained a significant mortality gap between the groups—the food-insecure group having an estimated 28 percent increased risk of all-cause mortality. 

Analyses of subsets of the respondents also showed that respondents reporting food insecurity and non-participation in government food assistance programs had about 42 percent increased risk of all-cause mortality—and 42 percent of increased risk of cancer mortality.  

This is the first study to review and find a connection between food insecurity and mortality in people with cancer. “Screening for food-insecurity in clinical practice, expanding food assistance program eligibility, and guiding people to resources may help reduce this apparent connection,” according to John Lin, a medical student and HEAL (Health Equity Advancement Lab) fellow at the Centers for Health Equity Advancement, and the study’s first author. 

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The Perelman School of Medicine is consistently among the nation's top recipients of funding from the National Institutes of Health, with $580 million awarded in the 2023 fiscal year. Home to a proud history of “firsts” in medicine, Penn Medicine teams have pioneered discoveries and innovations that have shaped modern medicine, including recent breakthroughs such as CAR T cell therapy for cancer and the mRNA technology used in COVID-19 vaccines. 

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