{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T10:33:03Z","timestamp":1793529183918,"version":"4.5.0"},"reference-count":52,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cancer Surviv"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Functional disability is common among cancer survivors, yet its contribution to multidimensional survivorship burden remains incompletely characterized. We evaluated disability-specific and sex-stratified associations with survivorship burden in a nationally representative US cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 2017\u20132022 Behavioral Risk Factor Surveillance System data among adult cancer survivors. Functional disability included mobility, cognitive, or self-care limitation. Outcomes included socioeconomic hardship (ordinal composite of inability to work and cost-related unmet care), psychological burden (frequent mental distress), and psychosocial burden (leisure-time physical inactivity). Survey-weighted regression models assessed associations by disability burden and type, with sex-stratified analyses and disability-by-sex interaction testing. Difference-in-differences analyses evaluated disability-associated socioeconomic hardship by Medicaid expansion status among low-income survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 3.57 million weighted cancer survivors, mobility (28.0%), cognitive (12.9%), and self-care (6.4%) disabilities were prevalent. Any disability was associated with higher socioeconomic hardship (aPOR 2.48, 95% CI 2.22\u20132.77), psychological burden (aOR 2.54, 95% CI 2.33\u20132.77), and psychosocial burden (aOR 2.68, 95% CI 2.48\u20132.89). Disability-specific patterns differed: cognitive disability was most strongly associated with psychological burden (aOR 3.42, 95% CI 3.02\u20133.87), self-care disability with socioeconomic hardship (aPOR 2.63, 95% CI 2.12\u20133.27), and mobility disability with psychosocial burden (aOR 2.98, 95% CI 2.70\u20133.29). Medicaid expansion modestly attenuated disability-associated socioeconomic hardship among low-income survivors. Disability-associated socioeconomic and psychological burden was greater among women, whereas psychosocial burden was more pronounced among men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Functional disability was strongly associated with multidimensional survivorship burden, with distinct disability- and sex-specific patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Cancer Survivors<\/jats:title>\n                    <jats:p>Disability-informed survivorship care may reduce hardship and improve post-cancer quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11764-026-01981-y","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T06:12:00Z","timestamp":1770876720000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Functional disability and multidimensional hardship among cancer survivors in the USA: a nationally representative study"],"prefix":"10.1007","author":[{"given":"Areesh","family":"Mevawalla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odysseas P.","family":"Chatzipanagiotou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azza","family":"Sarfraz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7994-9870","authenticated-orcid":false,"given":"Timothy M.","family":"Pawlik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"1981_CR1","unstructured":"Cancer prevalence: how many people have cancer? https:\/\/www.cancer.org\/cancer\/survivorship\/cancer-prevalence.html. 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