Abstract 4017: The prevalence of comorbid chronic conditions among cancer patients in the All of Us Research Program
Authors: Sue E. Kim, Crystal Rubalcava, Jennifer Tsui
Journal: Cancer Research (2025)

Abstract Cancer survivors in racial/ethnic minority, low socioeconomic status, and aging populations are more likely to have other chronic conditions, including 30% of cancer survivors who have diabetes or cardiovascular disease, many of which were pre-existing before cancer diagnosis. We examined the prevalence of comorbid chronic conditions among cancer patients in the All of Us Research Program (AoURP) cohort (2016-2024) and disease code identification from the National Library of Medicine and compared demographic, social determinants, and health-related social needs across specific cancer diagnosis sites. Comorbidities were self-reported data from the personal health history survey and found in electronic health records. We assessed the socioeconomic status (SES) barrier as a composite score (0-5) that combined education (≤ high school), income (≤ 35K), uninsured, housing (rent/other), and employment status (unemployed). We identified 12,415 breast cancer, 4,047 colorectal cancer (CRC), 3,126 lung cancer, and 7,951 prostate cancer cases among 574,000+ AoURP participants, as of Nov 2024. 54% of breast, 65% of colorectal, 76% of lung, and 57% of prostate cancer patients reported having at least 1 comorbid condition. About 20% had at least 2 comorbidities. Obesity and diabetes were the two most common conditions for breast and colorectal cancer, chronic pulmonary disease (CPD) and diabetes were the most common for lung cancer, and diabetes and moderate/severe kidney disease for prostate cancer. Among the other top 5 common comorbid conditions were rheumatoid arthritis, liver disease, and congestive heart failure. About a quarter of lung cancer patients with diabetes had 3 or more SES barriers, compared to 23% of colorectal, 20% of breast, and 12% of prostate cancer patients. Also, about 28% of lung cancer patients with liver disease had 3 or more SES barriers. A smaller proportion of CRC patients (19%) with obesity had 3 or more SES barriers, compared to 18% of lung, 13% of breast cancer, and 8% of prostate cancer patients. The highest proportion (&amp;gt;40%) of Black patients reported having diabetes for all cancer types, except prostate cancer (where Hispanic patients reported the highest rate). A higher proportion of Black patients with breast and colorectal cancer had obesity while similar proportions were reported between Hispanic and Black lung and prostate cancer patients. Understanding comorbidity prevalence in this national sample of cancer survivors provides insight into care coordination, disease management, and team-based care strategies needed to improve cancer survivorship care quality and address inequities in cancer survivorship outcomes. Further assessment of All of Us Research Program data, including patterns of care through EHR data and lab and self-reported survey data, may provide opportunities to comprehensively assess and intervene in survivorship care improvements. Citation Format: Sue E. Kim, Crystal Rubalcava, Jennifer Tsui. The prevalence of comorbid chronic conditions among cancer patients in the All of Us Research Program [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4017.