Abstract 5795: Long-term diabetes risk among ovarian cancer survivors in a population-based cohort study
Authors: Kim Seungmin , Rowe Kerry , Snyder John , Fraser Alison , Smith Ken , Deshmukh Vikrant G. , Newman Michael , Herget Kimberley , Chang Chun-Pin , Ose Dominik , Playdon Mary C. , Gaffney David , Hashibe Mia 
Published: September 2020

Objective. In the United States, ovarian cancer is the eleventh most common female cancer and the fifth most common cause of cancer death among women. Although incidence and death rates have been declining over the last 10 years, the 5-year survival rate is 47.6%. Diabetes was the seventh leading cause of death in the United States and is associated with an increased mortality rate among cancer patients. While previous studies have examined the association between diabetes and the risk of ovarian cancer, there are very few studies investigating the risk of diabetes after an ovarian cancer diagnosis. We previously reported increased risks of type I and II diabetes among endometrial cancer survivors, but there is no previous study, to our knowledge, that examined the risk of diabetes among ovarian cancer survivors. The aim of this study was to investigate long-term diabetes risk among ovarian cancer survivors compared with a general population of women.

Methods. Ovarian cancer patients diagnosed from 1996 to 2012 in the Utah Cancer Registry were matched to up to 5 cancer-free women on birth state and birth year using the Utah Population Database. Diabetes diagnoses were identified with ICD-9 codes from statewide ambulatory surgery records, statewide inpatient databases and electronic medical records. We estimated hazard ratios with Cox Proportional Hazards models to: (1) investigate risk for diabetes after cancer diagnosis among ovarian cancer survivors compared with the general population, and (2) examine risk factors for type II diabetes among ovarian cancer survivors.

Results. A total 1,520 ovarian cancer patients and 5,709 women from the general population were included in the final cohort. A slightly higher proportion of ovarian cancer patients were obese at baseline (16.3%) than the general population cohort (14.9%). Ovarian cancer survivors had a higher risk of type II diabetes in the first year after cancer diagnosis (HR=3.09, 95%CI=2.09, 4.56) and overall (HR=1.52, 95%CI=1.23, 1.88) compared with the general population. However, associations between ovarian cancer and type II diabetes were not observed in the later follow up periods. High BMI was a significant risk factor for type II diabetes among ovarian cancer survivors, with a dose-response relation (overweight; HR=1.81, 95%CI=1.21, 2.71, obese; HR=2.48, 95%CI=1.61, 3.83, P-trend &lt;0.001). Clinical factors such as cancer treatment, stage, and histology did not contribute to an increased risk of type II diabetes among ovarian cancer patients. Other factors such as race and baseline comorbidities were also not associated with type II diabetes risk among ovarian cancer patients.

Conclusion. Ovarian cancer survivors had an increased risk of type II diabetes compared with women in the general population. Risk was elevated only within the first year of cancer diagnosis, thus surveillance bias cannot be ruled out. Our findings suggest that the increased risk of type II diabetes does not persist beyond the first year after cancer diagnosis.

Citation Format: Seungmin Kim, Kerry Rowe, John Snyder, Alison Fraser, Ken Smith, Vikrant G. Deshmukh, Michael Newman, Kimberley Herget, Chun-Pin Chang, Dominik Ose, Mary C. Playdon, David Gaffney, Mia Hashibe. Long-term diabetes risk among ovarian cancer survivors in a population-based cohort study [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5795.