Background/Objectives:Cancer is the second leading cause of death in Puerto Rico, its impact worsened by an aging population. Many survivors experience long-term effects that reduce health-related quality of life (HRQoL). Chronic comorbidities are common in Puerto Rico, yet cancer survivors remain underrepresented in HRQoL research, raising concern about their impact on survivorship. This study examined whether comorbidity burden was associated with HRQoL and if patient navigation services or perceived social support moderated this association.Methods:This cross-sectional analysis included 643 cancer survivors from the START-PR study (November 2023–August 2025). HRQoL was measured using the Functional Assessment of Cancer Therapy—General (FACT-G) and dichotomized at the sample median (≤71 = poor; >71 = non-poor). Comorbidity burden was grouped as 0, 1, or ≥2 conditions. Patient navigation was assessed by self-reported service use in the past year. Perceived social support was measured using an adapted Multidimensional Scale of Perceived Social Support and dichotomized at the sample median (≤40 = low; >40 = high). Logistic regression estimated odds ratios (OR; 95% CI), adjusting for covariates. Interaction terms tested effect modification.Results:Participants with one (OR = 1.85; 95% CI: 1.15–2.97) or ≥2 comorbidities (OR = 2.95; 95% CI: 1.88–4.61) had significantly higher odds of poor HRQoL than those without comorbidities. Hypertension, depression, diabetes, arthritis, and asthma were more common among participants with poor HRQoL. Neither patient navigation nor perceived social support significantly moderated the comorbidity burden-HRQoL association.Conclusions:Greater comorbidity burden was associated with poor HRQoL. These findings underscore the need for survivorship care models that integrate chronic disease management, including mental health, to improve outcomes in underserved populations.
背景/目的：癌症是波多黎各第二大死因，人口老龄化加剧了其影响。许多幸存者经历着降低健康相关生活质量（HRQoL）的长期后遗症。慢性共病在波多黎各较为普遍，但癌症幸存者在HRQoL研究中代表性仍然不足，这引发了对其生存状况影响的担忧。本研究旨在探讨共病负担是否与HRQoL相关，以及患者导航服务或感知社会支持是否调节这种关联。 方法：这项横断面分析纳入START-PR研究（2023年11月至2025年8月）中的643名癌症幸存者。采用癌症治疗功能评估通用量表（FACT-G）测量HRQoL，并以样本中位数（≤71分为较差；>71分为非较差）进行二分处理。共病负担分为0、1或≥2种疾病。通过自我报告过去一年的服务使用情况评估患者导航服务。采用改编版多维感知社会支持量表测量感知社会支持，并以样本中位数（≤40分为低；>40分为高）进行二分处理。在调整协变量后，使用逻辑回归计算比值比（OR；95%置信区间）。通过交互项检验效应修饰作用。 结果：患有一种（OR = 1.85；95% CI：1.15–2.97）或≥2种共病（OR = 2.95；95% CI：1.88–4.61）的参与者，其HRQoL较差的风险显著高于无共病者。高血压、抑郁症、糖尿病、关节炎和哮喘在HRQoL较差的参与者中更为常见。患者导航服务和感知社会支持均未显著调节共病负担与HRQoL之间的关联。 结论：较高的共病负担与较差的HRQoL相关。这些发现强调，需要建立整合慢性疾病管理（包括心理健康）的生存照护模式，以改善医疗服务不足人群的健康结局。
肿瘤(癌症)患者之家