Increased risks of type II diabetes among older Asian, Native Hawaiian, and Pacific Islander lung cancer survivors: a SEER-Medicare analysis

Purpose Asian, Native Hawaiian, and Pacific Islanders (ANHPI) have a higher prevalence of type II diabetes compared to the non-Hispanic White (NHW) population. However, the incidence of type II diabetes among ANHPI lung cancer survivors is unknown. The aim of this study is to investigate the risk of newly diagnosed type II diabetes among older ANHPI lung cancer survivors compared to older NHW lung cancer survivors. Methods We identified 3920 ANHPI and 11,760 NHW lung cancer survivors diagnosed from 2000 to 2017 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of type II diabetes, adjusting for potential confounding factors. Results Older ANHPI lung cancer survivors had an increased risk of incident type II diabetes compared to older NHW lung cancer survivors > 1 year after cancer diagnosis. For specific ANHPI subgroups, increased risks of type II diabetes were observed among Asian Indian and Pakistani (HR, 5.14; 95% CI 2.10, 12.60) compared to NHW patients, followed by Native Hawaiian and Pacific Islander (NHPI) (HR, 4.38; 95% CI 1.22, 15.74), Vietnamese (HR, 2.32; 95% CI 1.29, 4.18), Korean (HR, 2.26; 95% CI 1.13, 4.54), Filipino (HR, 1.78; 95% CI 1.00, 3.16), and Chinese (HR, 1.75; 95% CI 1.10, 2.79) lung cancer survivors. Conclusion Older ANHPI lung cancer survivors had a higher risk of type II diabetes compared to older NHW lung cancer survivors. Further research is needed to examine the underlying causes of health disparities in diabetes risk among ANHPI lung cancer survivors.