PCN207 CANCER RISK AND RESOURCE UTILIZATION FOR 5 COMMON CANCERS IN A MATCHED CHINESE DIABETES POPULATION OF 331,000 PATIENTS

Abstract

It is recognised that cancer usually is not a disease in isolation and comorbidities may impact significantly on clinical management and cost of cancer treatment. Previous population-based studies have investigated the relation between cancer risk and diabetes. The objective of this study was to provide rigorous estimates of cancer incidence and health care utilization in a large Chinese diabetes population. A total of 331,490 diabetes patients were matched to controls (N=331,009) based on age, sex, city and insurance type using national administrative information of China Health Insurance Association (CHIRA) data in 2015. Odds ratios were used to compare the incidence of cancers in both groups. Descriptive statistics were used to compare the annual health care use and costs of cancer patients with and without diabetes. Regression analyses were used to compare specific cancer costs. All costs were reported in US dollars (based on $US1=6.228 Chinese Yuan). The average risk of cancer was significantly higher in diabetes patients compared to control subjects for both male (OR=1.4, [95%CI 1.4-1.5]) and female (1.3, [1.3-1.4]) patients. Diabetes was most frequently associated with pancreatic cancer, male (3.78, [2.39-5.98]), female (3.50, [2.13-5.75]). Cancer patients with diabetes had more outpatient consultations (33.2 vs. 23.6 visits) and a longer hospital length of stay (41.4 vs. 30.0 days) compared to matched controls. Average cost of treatment of cancer patients with diabetes per year was about $4,530 [4,070 to 4,990] more expensive than for patients without diabetes ($10,528). In particular treatment of GI cancers was 65-103% more costly compared to matched controls. Managing cancer in patients with diabetes on average is US$4,530 (>55%) more expensive compared to cancer patients without diabetes, due to extra admissions, increased length of stay per admission, and greater treatment costs, especially for patients with GI cancers.