1550-P: Trends in Cancer Mortality among U.S. Adults With and Without Diabetes, 1988-2015

Cancer-related mortality is higher among people with diabetes (DM) than people without DM. However, it is not known if this excess risk has changed over time. To estimate rates of cancer mortality in people with and without self-reported DM, we used data from adults aged ≥18 years who participated in the 1985-2012 National Health Interview Survey. Participants were linked to the National Death Index to determine vital status through the end of 2015. Cancer deaths were classified according to underlying cause of death. Death rates for five time periods (1988-1994, 1995-1999, 2000-2004, 2005-2009, 2010-2012) were estimated by survival analysis using Poisson regression models adjusted for age, sex and race/ethnicity with p for _trend reported. Among people with DM, overall cancer mortality (per 1,000 person-years) declined 34.1% from 4.1 (95% CI: 3.0-5.3) in 1988-1994 to 2.7 (2.3-3.2) in 2010-2015, p_trend<0.01. Among people without DM, overall cancer mortality declined 26.7% from 3.0 (2.8-3.2) to 2.2 (2.0-2.3), respectively for the 1988-1994 and 2010-2015 periods, p_trend<0.01. The excess rate of cancer mortality in people with vs. without DM did not change over time (from rate ratio 1.4 (1.0-1.8) in 1988-1994, to 1.3 (1.2-1.4) in 2010-2015). In this nationally representative study, cancer mortality rates declined in people with and without DM but cancer mortality rates remain 30% higher in people with DM. Future research could identify risk factors and prevention strategies for this excess risk.