ASPO Abstracts
Does having Type 2 Diabetes increase the odds of cervical cancer diagnosis? A nested case-control study of a Florida statewide multisite EHR database
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose: Our aim was to elucidate the relationship between Type 2 Diabetes (T2D) and cervical cancer diagnosis and to examine whether the intersectionality of race/ethnicity and T2D plays a role in c cervical cancer diagnosis. Methods: We analyzed statewide electronic health records (EHR) data from the OneFlorida+ Data Trust. We used an optimal matching algorithm to create 1:4 nested case-control dataset. Cases were defined as the patients with cervical cancer in the period 01/01/2012 to 12/31/2019. Controls were patients without a diagnosis of cervical cancer. We used statistics such as mean and standard deviation for continuous variables and frequency and proportion for discrete variables to describe the sample. We used conditional logistic regression to estimate the unadjusted and then the adjusted odds ratios (ORs) and associated 95% confidence intervals (CIs) to examine the association between cervical cancer and T2D. Results: The proportion of T2D among the sample without a cervical cancer diagnosis (n= 402,956) was 2.3%. The proportion of T2D among the sample with a cervical cancer diagnosis (n= 100,739) was 2.8%. A multivariable model examining the intersection of race/ethnicity and T2D status showed that after adjusting for sociodemographic characteristics, Non-Hispanic Black women with T2D had 58% higher odds of cervical cancer compared to non-Hispanic White women with T2D (OR: 1.58, 95% CI (1.41-1.77)). In the same multivariable model, factors associated with higher odds of cervical cancer included living in a rural area (OR: 1.39, 95% CI (1.34-1.44)), having Medicaid (OR: 2.16, 95% CI (2.12-2.21)) or Medicare (OR: 2.15, 95% CI (2.07-2.24), or living in an area with high social vulnerability (OR: 1.25, 95% CI (1.22-1.29)). Conclusions: Intersected with race, T2D is a significant predictor of getting a cervical cancer diagnosis. Non-Hispanic Black women who have T2D had a significantly higher odds of cervical cancer diagnosis compared to non-Hispanic White women with T2D. Black women with T2D may be especially vulnerable to cervical cancer. Our findings also add to the vast literature highlighting the need to address the higher burden of cervical cancer diagnosis among women living in poverty.
Keywords: Cervical Cancer, Type 2 Diabetes, Cancer Diagnosis, Intersectionality, Social vulnerability