Abstract B154: Cancer risk associated with type 2 diabetes among indigenous Medicaid beneficiaries in Arizona

Abstract Background: Type 2 diabetes (T2D) has been associated with increased risk of several cancers including endometrial, colorectal, and breast cancer. However, limited research has explored this association among Indigenous populations in the United States, groups that experience disproportionately high T2D prevalence and cancer disparities. The purpose of this study was to evaluate the association between type 2 diabetes (T2D) and the incidence of three diabetes associated cancers, endometrial, colorectal, and female breast cancer, among Indigenous and non-Indigenous Medicaid beneficiaries in Arizona. Methods: We conducted a retrospective cohort study using healthcare claims data from 519,460 beneficiaries enrolled between January 1, 2008 and December 31, 2021. Adjusted Poisson regression models were used to estimate cancer incidence rate ratios (IRRs) for individuals with versus without T2D, with analyses stratified by race and ethnicity. Results: T2D was associated with significantly elevated incidence rates of endometrial cancer (IRR=3.72***), female breast cancer (IRR=1.85***), and colorectal cancer (IRR=1.25). Stratified analyses indicated a potentially stronger association among Indigenous beneficiaries, though subgroup sample sizes limited statistical significance. Conclusions: These findings highlight new evidence of elevated cancer risk associated with T2D among Medicaid insured Indigenous individuals. This underscores the importance of integrating culturally grounded chronic disease and cancer prevention strategies in collaboration with tribal communities to address intersecting health inequities. Citation Format: Melinda S. Smith, Ricky Camplain, Nicolette Teufel-Shone. Cancer risk associated with type 2 diabetes among indigenous Medicaid beneficiaries in Arizona [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B154.