Abstract 1928: Racial/ethnic disparities in diabetes-related clinical care service use among cancer patients of cooccurring diabetes
Authors: Song Gaole , Ashing Kimlin Tam , Xie Bin 
Published: April 2023

Race/ethnicity is an important risk factor for both cancer and diabetes, many minority patients with cancer have diabetes as a comorbid condition but lack proper diabetes care and sufficient use.

Methods: Using The Behavioral Risk Factor Surveillance System 2017-2021 to study on adult patients diagnosed with cancer and diabetes and figure out if racial/ethnic disparities exist in diabetes-related clinical care service use including having ≥2 hemoglobin A1C tests, ≥1 eye examination, ≥1 foot examination annually by health professionals.

Results: Cohort included 66,991 cancer patients with cooccurring diabetes (77.2% non-Hispanic White (NHW), 9.2% Hispanic/Latinx, 9.3% non-Hispanic Black (HNB), 1.4% Asian American (AA), 1.1% American Indian or Alaskan Native (AIAN), 0.1% Pacific Islander (PI), and 1.7% Other (MRO)). Rao-Scott chi-square test suggested race/ethnicity was significantly associated with the completion of three recommended clinical care activities (χ2 R-S=121.3, DF=3.90, p&lt;0.0001). Compared to NHW patients, Hispanic/Latinx patients (OR=0.11, 95% CI=0.08, 0.16) and PI patients (OR=0.14, 95% CI=0.07, 0.30) had significantly lower odds of achieving all clinical healthcare activities. Multivariable logistic regression model predicting the completion of clinical care activities indicated patients who had healthcare insurance (OR=2.58, 95% CI=1.13, 5.90), routine check-up (OR=6.87, 95% CI= 1.60, 29.55), and healthcare providers (OR=5.60, 95% CI=2.52, 12.43) had significantly higher odds for full completions. Patients who used insulin (OR= 5.27, 95% CI=2.02, 13.75) and who had eyes affected by diabetes (OR= 2.18, 95% CI=1.08, 4.41) were more likely to complete annual clinical tests fully. Heavy drinkers were less likely to achieve all clinical care activities (OR=0.10, 95% CI=0.04, 0.24). Being older and well-educated, having better annual household incomes, being physically active were positively associated with annual clinical care service use.

Discussion: Patients with both cancer and diabetes have increased economic and medical burdens and need special care. Proper clinical care service use is important for reducing the risk of other long-term complications and burdens. However, racial/ethnic minority patients who have both cancer and diabetes are facing more barriers to accessing clinical care. Findings of this study addressed the lower rates of completing ADA recommendations of diabetes-related clinical care use among minority patients. Tailored clinical care services targeted to minority patients with low socioeconomic status are needed. Vulnerable patients should be provided with comprehensive patient-centered care services that take patients’ complex needs into account.

Citation Format: Gaole Song, Kimlin Tam Ashing, Bin Xie. Racial/ethnic disparities in diabetes-related clinical care service use among cancer patients of cooccurring diabetes [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1928.