Trajectories of body image distress among diverse young adult cancer survivors

Introduction: Body image distress (BID) is a psychological stressor for young adult cancer survivors (YACS), but its trajectory over time remains underexplored due to limited longitudinal data among this population. We examined how BID trajectories evolve as YACS progress throughout survivorship and assessed differences by Hispanic/Latino (H/L) ethnicity. Methods: YACS aged 18-39 years were recruited within 3 months of a de novo cancer diagnosis from two comprehensive cancer centers and a safety-net hospital, across all cancer stages. The 9-item Body Image Scale (BIS) assesses cancer-specific BID on a 5-point Likert scale, ranging from “not at all” to “very much”. The BIS was administered at three time points (baseline, 3 months, and 12 months); mean scores ≥ 10 were considered clinically meaningful. Latent Growth Curve Modeling (LGCM) was used to model and estimate longitudinal BID trajectories, with an unconditional model (model 1) for the overall trajectory and a conditional model (model 2) for ethnicity that included covariates of gender, socioeconomic status (SES), age at diagnosis, and education. Model fit indices evaluated the models. Results: Among the sample of 119 YACS, 56.3% were of H/L origin, 67.2% female, 44.5% were of low SES (<$40k), and 47.9% were college graduates or higher; participants had a mean age at diagnosis of 32.0 ( SD : 5.45). BID trajectories were slightly above the clinical threshold at all timepoints (baseline = 10.7; 3-month = 10.9; 12-month = 10.6; p > .10), suggesting that BID did not improve over time. Model 1 fit well (CFI = 1.00), the slope was non-significant ( p = .89), and the intercept showed significant variability ( p < .001), indicating individual differences in BID severity. Model 2 also fit well (CFI = 1.00); gender predicted higher BID, as females had significantly greater BID across all time points ( p < .001). By ethnicity, non-H/L YACS showed a gradual rise in BID over time, while H/L YACS had a slight decrease in BID over time, suggesting a protective trend; however, this trend was not significant ( p = .87). No relationship was found between SES, education, and age at diagnosis. Conclusion: Among YACS in this cohort, clinically significant BID persisted throughout the first year of survivorship and did not improve over time. Findings reveal a need for longitudinal monitoring of BID and the need for gender-specific interventions to mitigate BID throughout survivorship. Though non-significant, divergent directional trends by ethnicity suggest possible culturally informed protective factors that warrant further evaluation in larger samples.