Cancer burden among adults with type 2 diabetes mellitus in the United States, 1999-2023.

Abstract

e16480 Background: Type 2 Diabetes mellitus (T2DM) is associated with an increased risk of several cancers due to shared risk factors and diabetes-related metabolic disturbances such as insulin resistance, chronic inflammation, and hyperinsulinemia. This relationship may also be influenced by antidiabetic treatments and disease duration. Methods: Using CDC WONDER data for adults aged ≥25, we analyzed age-adjusted and crude mortality rates (AAMRs and CMRs) per 100,000 for Cancer (ICD-10 C00-D48 ) in T2DM (ICD-10 E11.0-E11.9 ) by year, sex, race/ethnicity, and geography. Joinpoint regression estimated average annual percentage change (AAPC) and annual percentage change (APC) with 95% confidence interval (CIs). Results: The total of 263,009 deaths related to cancer in type 2 Diabetes patients,in which most of deaths occur in Decedent's home.Overall, the AAMR increased from 2.73 (95% CI: 2.65–2.81) in 1999 to 7.08 (95% CI: 6.98–7.18) in 2023 (AAPC: 3.86 ; 95% CI: 2.90 to 4.83, p < 0.000001), with the most significant increase observed between 1999 and 2021 (APC:7.90 ; 95% CI: 6.30 to 9.53 , p < 0.000001). The increase in mortality was slightly more pronounced in women than in men (AAPC: 3.89 vs 3.78). The highest incidence rates were noted among non-Hispanic (NH) American Indian or Alaska Native, followed by NH Blacks or African Americans and Hispanics or Latino.Geographic disparities were apparent, with the West experiencing the greatest impact, while the Northeast was the least affected. Non- metropolitans consistently showed higher AAMR compared to metropolitan areas, though metropolitian locations experienced a steeper increase between the two (AAPC: 4.08 vs 3.80).The state with highest number of deaths was California (44,256). Conclusions: Patients with type 2 diabetes experience a substantial cancer burden, with notable variations across demographic and clinical subgroups. These findings highlight the need for integrated prevention strategies, early cancer screening, and optimized diabetes management to reduce cancer-related mortality in this high-risk population. Deaths and Age-adjusted Mortality Rates (AAMRs) per 100,000 for trends related to Cancer with Diabetes Mellitus type 2 from 1999 to 2023. Variable Deaths AAMR (95%CI) 1999 AAMR (95% CI)2023 Overall 263,009 2.73 (2.65 to 2.81) 7.08(6.98 to 7.18) Male 173,005 3.58(3.44 to 3.73) 9.22 (9.05 to 9.39) Female 114,207 2.2(2.11 to 2.29) 5.42(5.3 to 5.54) NH Blacks 27,906 3.56 (3.26 to 3.87) 7.83(7.49 to 8.17) NH Americans 2,352 3.55 (2.3 to 5.24) 10.57(9.02 to 12.11) West 72,938 2.07 (1.93 to 2.21) 11.43 (11.27 to 11.6) Northeast 35,527 2.79 (2.61 to 2.96) 5.52 (5.25 to 5.75) Metro 157,113 2.34 (2.27 to 2.42) (2020) 7.08 (6.96 to 7.2) Non- metro 48,079 4.34 ( 4.11 to 4.58) 12.14 (11.76 to 12.52)