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. 2025 Jun 3;34(6):998-1006.
doi: 10.1158/1055-9965.EPI-25-0037.

The Risk of Type 2 Diabetes among Older Asian, Native Hawaiian, and Pacific Islander Colorectal Cancer Survivors: A Population-Based Study Using the SEER-Medicare Database

Affiliations

The Risk of Type 2 Diabetes among Older Asian, Native Hawaiian, and Pacific Islander Colorectal Cancer Survivors: A Population-Based Study Using the SEER-Medicare Database

Kuangyu Liu et al. Cancer Epidemiol Biomarkers Prev. .

Abstract

Background: Although colorectal cancer survival rates are improving, the risk of incident type 2 diabetes mellitus (T2D) among Asian, Native Hawaiian, and Pacific Islander (ANHPI) ethnic groups is poorly understood. This study aims to identify high-risk groups and quantify the risk across different periods.

Methods: Using the SEER-Medicare database, colorectal cancer survivors who were ANHPI were matched to non-Hispanic White (NHW) survivors at a ratio of 1:3. Multivariable Cox regression models computed HRs and 95% confidence intervals (CI) for incident T2D.

Results: The study included 6,463 NHW and 2,901 ANHPI colorectal cancer survivors diagnosed between 2000 and 2017. Among them, 715 NHW and 484 ANHPI developed T2D during 39,097 and 10,769 person-years of follow-up, respectively. ANHPI colorectal cancer survivors had an elevated T2D risk compared with NHW across all follow-up periods (HRoverall: 1.84, 95% CI, 1.51-2.25; HR1-5 years: 1.83, 95% CI, 1.45-2.30). Southeast and East Asians demonstrated the highest T2D risks. Colon cancer was linked to early postdiagnosis T2D risk, whereas rectal cancer was associated with later risk. No significant association was observed for Native Hawaiians and Pacific Islanders.

Conclusions: ANHPI colorectal cancer survivors face a greater risk of T2D, particularly among Southeast and East Asians. These findings highlight the need for evidence-based survivorship strategies to prevent T2D and reduce ethnic disparities.

Impact: This is the first study to examine T2D risk among ANHPI colorectal cancer survivors, providing critical insights to inform tailored diabetes prevention and survivorship care.

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Conflict of interest statement

Disclosure of Potential Conflicts of Interest:

All authors declare they have no conflict of interests.

References

    1. Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. May-Jun 2024;74(3):229–263. doi: 10.3322/caac.21834 - DOI - PubMed
    1. Kim K, Yoon H. Health-Related Quality of Life among Cancer Survivors Depending on the Occupational Status. Int J Environ Res Public Health. Apr 6 2021;18(7)doi: 10.3390/ijerph18073803 - DOI - PMC - PubMed
    1. Harrop JP, Dean JA, Paskett ED. Cancer survivorship research: a review of the literature and summary of current NCI-designated cancer center projects. Cancer epidemiology, biomarkers & prevention. 2011;20(10):2042–2047. - PMC - PubMed
    1. Jiang C, Deng L, Karr MA, Wen Y, Wang Q, Perimbeti S, et al. Chronic comorbid conditions among adult cancer survivors in the United States: Results from the National Health Interview Survey, 2002-2018. Cancer. Feb 15 2022;128(4):828–838. doi: 10.1002/cncr.33981 - DOI - PMC - PubMed
    1. Khan NF, Mant D, Carpenter L, Forman D, Rose PW. Long-term health outcomes in a British cohort of breast, colorectal and prostate cancer survivors: a database study. British Journal of Cancer. 2011/November/01 2011;105(1):S29–S37. doi: 10.1038/bjc.2011.420 - DOI - PMC - PubMed

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