Abstract C074: Racial disparities in diabetes prevalence in prostate cancer patients on androgen deprivation therapy
Authors: Gomaa Sameh , Kelly Kevin , Mitchell Edith , LuYao Grace , Zhan Tingting , Wen Kuang-Yi 
Published: January 2023

Abstract
Background Androgen deprivation therapy (ADT) is successfully used in patients with advanced prostate cancer and has been shown to prolong survival. However, the use of ADT is associated with many side effects, most notably an increase in diabetes incidence for patients on ADT. African American men have higher prevalence and mortality rates from prostate cancer than Caucasian men. However, it is unclear how prostate cancer treatment such as ADT affects these disparities. This study examines racial differences in the prevalence of Diabetes mellitus in prostate cancer patients based on their ADT status in the US. Methods This is a retrospective cohort study. Data were sourced from US Collaborative Network TriNetX, a real-time EHR database providing patient data from 49 health care organizations (HCOs). Our cohorts of interest were diabetic prostate cancer patients PCA group identified by ICD-10 code C61, E08-E13 without ADT and PCA+ADT group – identified by ICD-10 code C61, E08-E13 and with ADT (AN500). Descriptive statistics. Prevalence and prevalence ratios were calculated for both PCA and PCA+ADT groups and followed by subgroup analysis by race. Results PCA group included 166,818 diabetic prostate cancer patients with a mean age of 73.5 (SD=13.7). PCA+ADT group included diabetic prostate cancer patients on ADT with a mean age of 75.9 (SD=10.5). The lifetime prevalence of diabetes mellitus in the PCA group is 25 per 100 patients, 69% (White), 14% (African American), and 1% (Asian). In the PCA+ADT group, the prevalence of diabetes is 28 per 100, 66% (White), 22% (African American), and 2% (Asian). Further subgroup analysis showed the prevalence of diabetes in the White population to be 26 per 100 patients in the (PCA+ADT) group, 37 per 100 patients in the African American population, and 34 per 100 patients in the Asian population. The prevalence ratio (PR) of having diabetes in the PCA+ADT group in comparison to the PCA group is PR=1.10 (95% CI=1.089-1.115), P&lt;0.001, Z=15.76. Further, the prevalence ratio (PR) comparing racial groups to the (PCA+ADT) was calculated. In the White group PR=0.938 (95% CI=0.921-0.955), P&lt;0.001, Z=7.059. In the African American group, PR=1.33 (95% CI= 1.296-1.362), P&lt;0.001, Z=22.24. In the Asian group, PR=1.204 (95% CI= 1.107-1.310), P&lt;0.001, Z=4.33 Conclusion The prevalence of diabetes is 10 % higher in the PCA+ADT group than in the PCA group, and further subgroup analysis demonstrated a racial difference in the prevalence of diabetes. In the African American group, diabetes prevalence was higher by 33 % than in the PCA+ADT group. In the Asian group, it was higher by 20%. The white group had a lower prevalence of diabetes by 6.2 % than the PCA+ADT group. The results suggest racial disparities necessitating increased screening efforts and urgent diabetes mellitus management and control.
Citation Format: Sameh Gomaa, Kevin Kelly, Edith Mitchell, Grace LuYao, Tingting Zhan, Kuang-Yi Wen. Racial disparities in diabetes prevalence in prostate cancer patients on androgen deprivation therapy [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C074.