Abstract B148: Prevalence of Multimorbidity Among Patients with Newly Diagnosed Cancer at a Safety-Net Health System
Authors: Singh Anand B. , Lu Yan , Gehr Aaron W , Narra Kalyani , Tanna Bhavna , Bullock Jolonda , Meadows Rachel J. 
Published: September 2024

Background: Multimorbidity (MM) presents challenges for cancer care and may require coordination between oncologists and primary or specialty care providers. Nevertheless, U.S.-based studies of MM among cancer patients have mostly been conducted in non-Hispanic White and insured populations, which limits understanding of strategic care planning and resource allocation among more diverse populations. Therefore, we aimed to assess the prevalence of MM among adults with newly diagnosed cancer at a large, racial/ethnically diverse safety-net health system. Methods: We used electronic health record and cancer registry data from JPS Health Network, an urban safety-net health system in North Texas. Our eligible population included patients ≥18 years of age diagnosed with first primary cancer in 2016 – 2020 (excluding in situ cases), whose diagnosis or first-course cancer treatment was received at JPS. Our outcomes of interest were MM (≥2 chronic conditions) and severe MM (≥3 chronic conditions) based on 30 chronic conditions defined by the Centers for Medicare & Medicaid Services with up to a 2-year lookback period before cancer diagnosis. We assessed overall and sub-group specific (age group, sex, and race/ethnicity) prevalence of MM and severe MM. We estimated prevalence differences (PD) and 95% confidence intervals between groups using pairwise comparisons with Bonferroni correction. Results: Our study population comprised 5,019 newly diagnosed adult cancer patients. The median age was 58 years and the majority were females (51%), racial/ethnic minorities (59%), uninsured (51%), and overweight or obese (69%). The most common cancer types were breast (13%), lung (12%), and colorectal (11%). Nearly half (45%) were diagnosed with advanced stage cancer. A high proportion of cancer patients had MM (79%) and severe MM (62%). The most common conditions were hypertension (55%), anemia (36%), hyperlipidemia (31%), diabetes (27%), and depressive mood disorders (22%). MM increased by age: 56% among patients aged 18 – 39 years, 78% among patients aged 40 – 64 years, and 91% among patients aged ≥65 years. A higher proportion of males had MM (PD: 6.0% [95% CI: 3.8%, 8.3%]) and severe MM (PD: 7.5% [95% CI: 4.9%, 10%]) compared with females. By race/ethnicity, Non-Hispanic Black patients had the highest prevalence of MM (PD: 8.1% [95% CI: 4.3%, 12%]) and severe MM (PD: 11% [95% CI: 6.7%, 16%]) compared with the lowest prevalences among Hispanic patients. Conclusions: We observed a high prevalence of MM and severe MM among adult cancer patients, particularly among patients aged ≥45 years and non-Hispanic Black patients. Our estimates were &gt;15% higher than prior studies that included mostly non-Hispanic White adult cancer survivors with higher socioeconomic status. Our findings provide insight about the burden of MM among racially diverse cancer patients with low socioeconomic status, which may inform resource allocation and care coordination initiatives to manage MM.

Citation Format: Anand B. Singh, Yan Lu, Aaron W Gehr, Kalyani Narra, Bhavna Tanna, Jolonda Bullock, Rachel J. Meadows. Prevalence of Multimorbidity Among Patients with Newly Diagnosed Cancer at a Safety-Net Health System [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B148.