Health Care Use Among Cancer Patients With Diabetes, National Health and Nutrition Examination Survey, 2017–2020

TL;DR

This study found that cancer patients with prediabetes had more healthcare visits than those without diabetes, but type 2 diabetes did not significantly increase healthcare use.

Contribution

The study provides new insights into healthcare use patterns among cancer patients with diabetes or prediabetes using recent NHANES data.

Findings

24.4% of cancer patients had type 2 diabetes, and 25.8% had prediabetes.

Prediabetes was associated with a 11% higher rate of healthcare visits compared to cancer-only patients.

Type 2 diabetes did not significantly affect healthcare visits or hospital stays compared to cancer-only patients.

Abstract

Diabetes is a common comorbidity among people with cancer. The objective of our study was to examine patterns of health care use among patients with cancer and either type 2 diabetes or prediabetes.

We used data from the National Health and Nutrition Examination Survey (NHANES) for 2017–2020. The study population included US adults aged 18 years or older who were diagnosed with any cancer and type 2 diabetes or prediabetes (established by self-report and/or hemoglobin A1c measurement). We used Poisson and multivariate logistic regression models to determine the effect of comorbidity on health care use, defined as health care visits and overnight stays in a hospital.

Of 905 cancer patients representing 27,180,715 people in the US, 24.4% had a type 2 diabetes diagnosis, and 25.8% had a prediabetes diagnosis. Patients with cancer and prediabetes had a significantly higher rate of health care visits (incidence rate ratio = 1.11; 95% CI, 1.01–1.22; P = .03) than patients with cancer only. We found no significant association between having cancer and type 2 diabetes and the number of health care visits or overnight hospital stays compared with patients with cancer only.

More emphasis should be placed on optimal care coordination among people with cancer and other conditions, such as diabetes and prediabetes, to reduce the impact of comorbidity on health care use. Interventions integrated with technology to provide timely access to education on preventing or managing diabetes and prediabetes among cancer patients are warranted.