Abstract
Introduction: More than 100 million Americans have diabetes or pre-diabetes and 1.7 million new cancer diagnoses are expected in 2019. A strong link exists between type 2 diabetes (T2D) and several forms of cancer including liver, pancreatic, and colorectal cancers. Additionally, the prevalence of comorbidities such as hypertension, cardiovascular disease, and depression among patients with cancer is common and can affect prognosis, treatment outcomes, and survival rates of patients. However, little is known about how comorbidities differ among cancer patients with and without diabetes across racial and ethnic groups. Therefore, we compared comorbidities, among adult hospice cancer patients with and without diabetes. Methodology: Of 233 adults with cancer, 51 (mean age 69.9±11.9) reported they also had diabetes and 182 (mean age 67.9±14.6) did not report diabetes. Both groups were 51% male and 55% racial/ethnic minorities (35% Black, 20% Hispanic among those with diabetes; 34% Black, 19% Hispanic among those without diabetes). Results: The number of comorbidities differed significantly between groups; patients with diabetes experienced twice as many (excluding diabetes) comorbidities (4.0±3.2 vs 1.8±1.9, p<0.001). Black patients (n=79) had more comorbidities than non-Hispanic Whites (n=104) (3.1±3.0 vs 1.8±2.0, p=.001). The disparity was especially severe for Blacks with cancer and diabetes (n=18): not counting diabetes, they had on average 5.8±3.5 comorbidities compared to 3.2±2.9 for non-Hispanic Whites with diabetes (p=.01). The difference between non-Hispanic Whites (n=104) and Hispanics (n=44) on comorbidities, however, was not statistically significant (1.8±2.0 vs 2.2±1.6, p=.19). Conclusions: Findings revealed significant differences in the number of comorbidities between patients with and without diabetes. Patients with cancer and diabetes experienced twice as many comorbidities than those without diabetes while Black patients with cancer and diabetes experienced nearly twice as many comorbidities compared to non-Hispanic Whites. The co-occurrence of chronic health conditions in patients with cancer and diabetes can have a negative impact on cancer outcomes. Patients with comorbidities are less likely to receive curative treatment for their cancer and are more likely to experience complications. More research is needed to investigate comorbidity risks in patients with cancer and diabetes across racial and ethnic groups to elicit a better understanding of the complexity of patients with multiple comorbidities in an effort to decrease disparities and improve cancer outcomes. Additional prospective research is needed with additional diabetes-related variables (e.g., type of diabetes, HgA1C) to better understand comorbidities among racial and ethnic cancer populations.
Citation Format: Lisa Scarton, Yingwei Yao, Diana J Wilkie. Occurrence of comorbidities among diverse hospice cancer patients with and without diabetes [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B026.
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