{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:08:55Z","timestamp":1788930535845,"version":"build-2803163510"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Social isolation and loneliness are associated with mortality, but their impact on cause-specific mortality in cancer survivors remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cohort study enrolled UK Biobank participants with cancer at baseline, followed up from March 2006 to September 2024. Social isolation and loneliness were assessed by self-reported questionnaires. Outcomes included all-cause, cancer-specific, and cardiovascular disease (CVD)-related mortality. Associations were evaluated using Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 32,524 participants were included in this study (60.2% women; mean age, 60.3 years). During a median 15.7-year follow-up, 5,945 deaths occurred. Social isolation was significantly associated with increased all-cause (HR, 1.22; 95%CI, 1.12\u20131.32), cancer-specific (HR, 1.16; 95%CI, 1.04\u20131.28), and CVD-related (HR, 1.32; 95%CI, 1.07\u20131.63) mortality. Loneliness was not associated with all-cause mortality (HR, 0.98; 95%CI, 0.93\u20131.04), but independently associated with increased CVD-related mortality (HR, 1.26; 95%CI, 1.08\u20131.47). Exploratory analyses identified distinct prognostic impacts of specific isolation measures: living alone was linked to higher all-cause and non-cancer mortality across most cancer types, while weekly social activities and monthly family\/friends visits were protective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Social isolation was associated with increased risks of all-cause, cancer-specific, and CVD-related mortality. Loneliness was associated with elevated CVD-related mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1908858","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:40:39Z","timestamp":1788928839000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Social isolation and loneliness and mortality among cancer survivors: a prospective cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Ran","family":"Ran","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manyun","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruohan","family":"Liu","sequence":"additional","affiliation":[{"name":"The Comprehensive Breast Care Center, The Second Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Yang","sequence":"additional","affiliation":[{"name":"Cancer Center, The First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi\u2019an Jiaotong University","place":["Xi\u2019an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.70011","article-title":"Cancer treatment and survivorship statistics, 2025","volume":"75","author":"Wagle","year":"2025","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djac037","article-title":"Overcoming obstacles in transitions of cancer survivor care","volume":"114","author":"Morgans","year":"2022","journal-title":"J Natl Cancer Inst"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/132.11.3494s","article-title":"Cancer survivorship research: challenge and opportunity","volume":"132","author":"Aziz","year":"2002","journal-title":"J Nutr"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-psych-122216-011902","article-title":"Why social relationships are important for physical health: a systems approach to understanding and modifying risk and protection","volume":"69","author":"Holt-Lunstad","year":"2018","journal-title":"Annu Rev Psychol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1511085112","article-title":"Social relationships and physiological determinants of longevity across the human life span","volume":"113","author":"Yang","year":"2016","journal-title":"Proc Natl Acad Sci USA"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1126\/science.3399889","article-title":"Social relationships and health","volume":"241","author":"House","year":"1988","journal-title":"Science"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1177\/1745691614568352","article-title":"Loneliness and social isolation as risk factors for mortality: a meta-analytic review","volume":"10","author":"Holt-Lunstad","year":"2015","journal-title":"Perspect Psychol Sci"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1177\/0898264312460275","article-title":"Social isolation, loneliness and health among older adults","volume":"24","author":"Coyle","year":"2012","journal-title":"J Aging Health"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308790","article-title":"Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies","volume":"102","author":"Valtorta","year":"2016","journal-title":"Heart"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2017-312663","article-title":"Social isolation and loneliness as risk factors for myocardial infarction, stroke and mortality: UK Biobank cohort study of 479 054 men and women","volume":"104","author":"Hakulinen","year":"2018","journal-title":"Heart"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1177\/17579139211016077","article-title":"Associations of loneliness and social isolation with physical and mental health among adolescents and young adults","volume":"141","author":"Christiansen","year":"2021","journal-title":"Perspect Public Health"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.52824","article-title":"Improvement of social isolation and loneliness and excess mortality risk in people with obesity","volume":"7","author":"Zhou","year":"2024","journal-title":"JAMA Netw Open"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad655.3008","article-title":"Association between psychological distress and cardiovascular health amongst cancer survivors in the United States: findings from nationally representative data","volume":"30","author":"Chan","year":"2023","journal-title":"Eur J Prev Cardiol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwae318","article-title":"Associations between social determinants of health and cardiovascular and cancer mortality in cancer survivors: a prospective cohort study","volume":"32","author":"Chan","year":"2024","journal-title":"Eur J Prev Cardiol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2023.7114","article-title":"Loneliness and mortality risk among cancer survivors in the United States: a retrospective, longitudinal study","volume":"22","author":"Zhao","year":"2024","journal-title":"J Natl Compr Canc Netw"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0173370","article-title":"Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults","volume":"12","author":"Fleisch Marcus","year":"2017","journal-title":"PloS One"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1002\/pon.70066","article-title":"Connections after cancer: adolescent and young adult survivors' perspectives on forming new friendships after cancer","volume":"34","author":"Miron","year":"2025","journal-title":"Psychooncology"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.16675","article-title":"Social connectedness and health-related quality of life among patients with cancer undergoing chemotherapy: a mixed method approach using structural equation modelling and photo-elicitation","volume":"32","author":"Salazar","year":"2023","journal-title":"J Clin Nurs"},{"key":"B19","doi-asserted-by":"publisher","first-page":"4710","DOI":"10.3390\/cancers15194710","article-title":"Interventions with social integration components addressing psychosocial outcomes of young- and middle-aged adult cancer individuals: a systematic review","volume":"15","author":"Poudel","year":"2023","journal-title":"Cancers (Basel)"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djaf141","article-title":"Identifying and mitigating the biological effectors of the social determinants of health in cancer","volume":"117","author":"Wagner","year":"2025","journal-title":"J Natl Cancer Inst"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001779","article-title":"UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age","volume":"12","author":"Sudlow","year":"2015","journal-title":"PloS Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/s2468-2667(17)30075-0","article-title":"Contribution of risk factors to excess mortality in isolated and lonely individuals: an analysis of data from the UK Biobank cohort study","volume":"2","author":"Elovainio","year":"2017","journal-title":"Lancet Public Health"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-020-01878-2","article-title":"Association between patterns of alcohol consumption (beverage type, frequency and consumption with food) and risk of adverse health outcomes: a prospective cohort study","volume":"19","author":"Jani","year":"2021","journal-title":"BMC Med"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyac022","article-title":"Ambient air pollution, healthy diet and vegetable intakes, and mortality: a prospective UK Biobank study","volume":"51","author":"Wang","year":"2022","journal-title":"Int J Epidemiol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa1031","article-title":"Joint exposure to various ambient air pollutants and incident heart failure: a prospective analysis in UK Biobank","volume":"42","author":"Wang","year":"2021","journal-title":"Eur Heart J"},{"key":"B26","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1038\/s43016-024-01059-x","article-title":"Proteomic signatures of healthy dietary patterns are associated with lower risks of major chronic diseases and mortality","volume":"6","author":"Zhu","year":"2025","journal-title":"Nat Food"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.18.1737","article-title":"Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire","volume":"282","author":"Spitzer","year":"1999","journal-title":"Jama"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dym276","article-title":"The UK Biobank sample handling and storage protocol for the collection, processing and archiving of human blood and urine","volume":"37","author":"Elliott","year":"2008","journal-title":"Int J Epidemiol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4067","article-title":"Multiple imputation using chained equations: issues and guidance for practice","volume":"30","author":"White","year":"2011","journal-title":"Stat Med"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3618","article-title":"Imputing missing covariate values for the Cox model","volume":"28","author":"White","year":"2009","journal-title":"Stat Med"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1219686110","article-title":"Social isolation, loneliness, and all-cause mortality in older men and women","volume":"110","author":"Steptoe","year":"2013","journal-title":"Proc Natl Acad Sci USA"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-025-02894-4","article-title":"Association of social isolation and loneliness with incident cardiovascular diseases: results from a nationally prospective cohorts in China","volume":"61","author":"Zha","year":"2025","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbae018","article-title":"Loneliness trajectories predict risks of cardiovascular diseases in Chinese middle-aged and older adults","volume":"79","author":"Huang","year":"2024","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.46461","article-title":"Evaluation of social isolation, loneliness, and cardiovascular disease among older women in the US","volume":"5","author":"Golaszewski","year":"2022","journal-title":"JAMA Netw Open"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1093\/abm\/kaaa044","article-title":"Loneliness, social isolation, and chronic disease outcomes","volume":"55","author":"Christiansen","year":"2021","journal-title":"Ann Behav Med"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2022.06.005","article-title":"Impact of social vulnerability on comorbid cancer and cardiovascular disease mortality in the United States","volume":"4","author":"Ganatra","year":"2022","journal-title":"JACC CardioOncol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2023.07.010","article-title":"Associations between social determinants of health and cardiovascular health of U.S. adult cancer survivors","volume":"6","author":"Satti","year":"2024","journal-title":"JACC CardioOncol"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2024.02.009","article-title":"Social determinants of health in cardio-oncology: multi-level strategies to overcome disparities in care: JACC: CardioOncology state-of-the-art review","volume":"6","author":"Osei Baah","year":"2024","journal-title":"JACC CardioOncol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1186\/s12916-023-03055-7","article-title":"Social connection and mortality in UK Biobank: a prospective cohort analysis","volume":"21","author":"Foster","year":"2023","journal-title":"BMC Med"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0000000000000710","article-title":"Loneliness, living alone, and all-cause mortality: the role of emotional and social loneliness in the elderly during 19 years of follow-up","volume":"81","author":"O\u2019S\u00failleabh\u00e1in","year":"2019","journal-title":"Psychosom Med"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-012-2253-8","article-title":"Social networks, social support, and burden in relationships, and mortality after breast cancer diagnosis in the Life After Breast Cancer Epidemiology (LACE) study","volume":"137","author":"Kroenke","year":"2013","journal-title":"Breast Cancer Res Treat"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-010-0139-5","article-title":"Social networks and survival after breast cancer diagnosis","volume":"4","author":"Beasley","year":"2010","journal-title":"J Cancer Surviv"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30440","article-title":"Postdiagnosis social networks and breast cancer mortality in the After Breast Cancer Pooling Project","volume":"123","author":"Kroenke","year":"2017","journal-title":"Cancer"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1002\/pon.70013","article-title":"Social support, social strain, stressful life events and mortality among postmenopausal women with breast cancer","volume":"33","author":"Wang","year":"2024","journal-title":"Psychooncology"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-010-9822-2","article-title":"Psychosocial interventions to improve quality of life in prostate cancer survivors and their intimate or family partners","volume":"20","author":"Badger","year":"2011","journal-title":"Qual Life Res"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-014-0361-7","article-title":"Psychosocial interventions to support partners of men with prostate cancer: a systematic and critical review of the literature","volume":"8","author":"Wootten","year":"2014","journal-title":"J Cancer Surviv"},{"key":"B47","doi-asserted-by":"publisher","first-page":"2150","DOI":"10.3390\/ijms18102150","article-title":"Hypothalamic-pituitary-adrenal axis modulation of glucocorticoids in the cardiovascular system","volume":"18","author":"Burford","year":"2017","journal-title":"Int J Mol Sci"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1089\/ars.2017.7312","article-title":"Loneliness, social isolation, and cardiovascular health","volume":"28","author":"Xia","year":"2018","journal-title":"Antioxid Redox Signal"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.96.23.13357","article-title":"Down-regulation of the expression of endothelial NO synthase is likely to contribute to glucocorticoid-mediated hypertension","volume":"96","author":"Wallerath","year":"1999","journal-title":"Proc Natl Acad Sci USA"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1037\/a0017805","article-title":"Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults","volume":"25","author":"Hawkley","year":"2010","journal-title":"Psychol Aging"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2019.08.189","article-title":"Social engagement and loneliness are differentially associated with neuro-immune markers in older age: Time-varying associations from the English Longitudinal Study of Ageing","volume":"82","author":"Walker","year":"2019","journal-title":"Brain Behav Immun"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1908858\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T04:40:48Z","timestamp":1788928848000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1908858\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":51,"alternative-id":["10.3389\/fonc.2026.1908858"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1908858","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"1908858"}}