---
title: "Type 2 Diabetes Risk in Older ANHPI Head and Neck Cancer Survivors in the US"
id: "pubmed-42665904"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42665904"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42665904/"
doi: "10.1002/cam4.72227"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Type 2 Diabetes Risk in Older ANHPI Head and Neck Cancer Survivors in the US
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42665904
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42665904/)
- **DOI:** [10.1002/cam4.72227](https://doi.org/10.1002%2Fcam4.72227)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Using SEER-Medicare data from 2000–2019, investigators evaluated incidence and risk factors for **Type 2 diabetes** among older (≥66 years) patients with **head and neck cancer** (HNC), comparing Asian, Native Hawaiian, and Pacific Islander (ANHPI) subgroups with non-Hispanic White (NHW) patients. - Cohort sizes reported: 2,862 older NHW, 423 East Asian, 211 Southeast Asian, 139 South Asian, and 68 Native Hawaiian and Pacific Islander (NHPI) HNC survivors. - Incidence >1 year after cancer diagnosis varied by group: South Asian survivors had the highest cumulative incidence (19.4%), other ANHPI subgroups ranged 7%–14%, and NHW survivors had 7.5%. - Relative risks (Fine-Gray subdistribution hazard models) showed elevated diabetes hazard for East Asian (HR 2.04; 95% CI 1.36–3.06; incidence 14.0%) and South Asian (HR 3.34; 95% CI 1.86–6.00) survivors compared with NHW survivors >1 year after diagnosis. - Elevated diabetes risk was particularly notable among Chinese and Asian Indian/Pakistani HNC survivors when compared to NHW, East Asian, or Chinese reference groups. - The study reports a roughly 2- to 3-fold higher risk of developing **Type 2 diabetes** for ANHPI HNC survivors versus NHW HNC survivors. - Authors highlight a need for targeted diabetes prevention for East and South Asian HNC patients and caution that findings for small subgroups (Korean, Vietnamese, NHPI) are limited by counts <100 and CMS cell-size suppression for n<11. - Study methods included use of SEER-Medicare linkage and Fine-Gray competing risk models; exact variable selection and additional covariates were not detailed in the abstract. - The authors declare no conflicts of interest and emphasize cardiometabolic disparities in ANHPI cancer survivorship.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Huntsman Cancer Institute, Salt Lake City, Utah, USA. * 2 Division of Public Health, Department of Family Medicine and Public Health, University of Utah School of Medicine, Salt Lake City, Utah, USA. * 3 Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA. * 4 Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA. * PMID: **42665904** * PMCID: [ PMC13525158 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13525158/) * DOI: [ 10.1002/cam4.72227 ](https://doi.org/10.1002/cam4.72227) Item in Clipboard # Type 2 Diabetes Risk Among Older Asian, Native Hawaiian and Pacific Islander Patients With Head and Neck Cancer in the United States Chun-Pin Esther Chang et al. Cancer Med. 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID Cancer Med Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cancer+Med%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Cancer+Med%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42665904/) . 2026 Sep;15(9):e72227. doi: 10.1002/cam4.72227. ### Authors [Chun-Pin Esther Chang](https://pubmed.ncbi.nlm.nih.gov/?term=Chang+CE&cauthor_id=42665904)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42665904/#short-view-affiliation-1 "Huntsman Cancer Institute, Salt Lake City, Utah, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42665904/#short-view-affiliation-2 "Division of Public Health, Department of Family Medicine and Public Health, University of Utah School of Medicine, Salt Lake City, Utah, USA."), [Sarah M Drejet](https://pubmed.ncbi.nlm.nih.gov/?term=Drejet+SM&cauthor_id=42665904)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42665904/#short-view-affiliation-1 "Huntsman Cancer Institute, Salt Lake City, Utah, USA.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665904/#short-view-affiliation-3 "Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA."), [Jason P Hunt](https://pubmed.ncbi.nlm.nih.gov/?term=Hunt+JP&cauthor_id=42665904)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665904/#short-view-affiliation-3 "Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA."), [Marcus Monroe](https://pubmed.ncbi.nlm.nih.gov/?term=Monroe+M&cauthor_id=42665904)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42665904/#short-view-affiliation-1 "Huntsman Cancer Institute, Salt Lake City, Utah, USA.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42665904/#short-view-affiliation-3 "Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA."), [Mia Hashibe](https://pubmed.ncbi.nlm.nih.gov/?term=Hashibe+M&cauthor_id=42665904)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42665904/#short-view-affiliation-1 "Huntsman Cancer Institute, Salt Lake City, Utah, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42665904/#short-view-affiliation-2 "Division of Public Health, Department of Family Medicine and Public Health, University of Utah School of Medicine, Salt Lake City, Utah, USA.")[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42665904/#short-view-affiliation-4 "Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA.") ### Affiliations * 1 Huntsman Cancer Institute, Salt Lake City, Utah, USA. * 2 Division of Public Health, Department of Family Medicine and Public Health, University of Utah School of Medicine, Salt Lake City, Utah, USA. * 3 Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA. * 4 Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA. * PMID: **42665904** * PMCID: [ PMC13525158 ](https://pmc.ncbi.nlm.nih.gov/articles/PMC13525158/) * DOI: [ 10.1002/cam4.72227 ](https://doi.org/10.1002/cam4.72227) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract Diabetes is one of the most prevalent comorbidities among patients with head and neck cancer (HNC), and its burden is disproportionately higher in Asian American, Native Hawaiian, and Pacific Islander (ANHPI) populations. However, the incidence and risk factors for diabetes among ANHPI HNC patients remain unknown. The aim of our study was to examine the incidence and risk factors of developing Type 2 diabetes among older (≥ 66 years of age) ANHPI HNC patients in the United States, as well as differences across ANHPI subgroups. Using the SEER-Medicare linked database, we identified Non-Hispanic White (NHW) and ANHPI patients diagnosed with HNC from 2000 to 2019. Fine-Gray subdistribution hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for diabetes among ANHPI subgroups compared to three reference groups: NHW, East Asian, or Chinese HNC patients. The study included 2862 older NHW, 423 East Asian, 211 Southeast Asian, 139 South Asian, and 68 NHPI HNC survivors. South Asian HNC survivors had the highest incidence of Type 2 diabetes (19.4%) compared to other ANHPI subgroups (7%-14%) and non-Hispanic White (NHW) HNC survivors (7.5%) > 1 year after cancer diagnosis. East Asian (HR: 2.04; 95% CI: 1.36, 3.06; incidence: 14.0%) and South Asian (HR: 3.34; 95% CI: 1.86, 6.00) HNC survivors had higher diabetes risks compared to NHW HNC survivors > 1 year after cancer diagnosis, notably among Chinese and Asian Indian/Pakistani HNC survivors. Our results showed a 2- to 3-fold difference in risk of Type 2 diabetes for ANHPI HNC survivors compared to NHW HNC survivors. There was a high incidence of diabetes, especially in the South and East Asian HNC patients, highlighting the need for prevention in these groups. Small sample sizes among ANHPI subgroups with fewer than 100 HNC patients (Korean, Vietnamese, NHPI) warrant cautious interpretation of these findings. **Keywords:** Asian; cardiometabolic disparities; diabetes; head and neck cancer survivorship; native Hawaiian and Pacific islanders. © 2026 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Precis: Asian American, Native Hawaiian, and Pacific Islander (ANHPI) head and neck cancer (HNC) survivors had a 2‐ to 3‐fold higher risk of developing Type 2 diabetes compared to non‐Hispanic White (NHW) survivors. The elevated incidence, particularly among South and East Asian groups, underscores the urgent need for targeted diabetes prevention strategies in these populations. The authors declare no conflicts of interest. ## Figures [ ![FIGURE 1](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d931/13525158/4b07a0b71b67/CAM4-15-e72227-g001.gif) ](https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d931/13525158/4739ba6a5183/CAM4-15-e72227-g001.webp) ** FIGURE 1 ** Prevalence and incidence of Type… ** FIGURE 1 ** Prevalence and incidence of Type 2 diabetes among patients with head and neck… **FIGURE 1** Prevalence and incidence of Type 2 diabetes among patients with head and neck cancer in the SEER‐Medicare data.b Prevalence at cancer diagnosis; incidence > 1 year after diagnosis. ANHPI, Asian, Native Hawaiian, and Pacific Islander; NHPI, Native Hawaiian and Pacific Islander; NHW, Non‐Hispanic White. aPercentages were suppressed according to the U.S. Department of Health and Human Services CMS cell size suppression policy (_n_ < 11). bIncidence of Type 2 diabetes was assessed as a cumulative incidence proportion, calculated as the number of patients who developed Type 2 diabetes more than 1 year after cancer diagnosis divided by the number of patients at risk for Type 2 diabetes during that period. [See this image and copyright information in PMC](https://pubmed.ncbi.nlm.nih.gov/42665904/) ## Similar articles * [ The Risk of Type 2 Diabetes among Older Asian, Native Hawaiian, and Pacific Islander Colorectal Cancer Survivors: A Population-Based Study Using the SEER-Medicare Database. ](https://pubmed.ncbi.nlm.nih.gov/40227116/) Liu K, Chang CE, Lloyd S, Tao R, Nguyen T, Zhang ZF, Hashibe M.Liu K, et al.Cancer Epidemiol Biomarkers Prev. 2025 Jun 3;34(6):998-1006. doi: 10.1158/1055-9965.EPI-25-0037.Cancer Epidemiol Biomarkers Prev. 2025.PMID: 40227116Free PMC article. * [ Incident cardiovascular disease risk among older Asian, Native Hawaiian and Pacific Islander liver cancer survivors. ](https://pubmed.ncbi.nlm.nih.gov/39362079/) Wang J, Pan Y, Chang CE, Daud A, Tao R, Hashibe M.Wang J, et al.Cancer Epidemiol. 2024 Dec;93:102680. doi: 10.1016/j.canep.2024.102680. Epub 2024 Oct 2.Cancer Epidemiol. 2024.PMID: 39362079 * [ Survival disparities among Asian, Native Hawaiian and Pacific Islander (ANHPI) patients with non-Hodgkin lymphoma (NHL) in the United States. ](https://pubmed.ncbi.nlm.nih.gov/39862332/) Chang CE, Wang J, Lee C, Hashibe M.Chang CE, et al.Cancer Causes Control. 2025 Jun;36(6):605-615. doi: 10.1007/s10552-025-01964-x. Epub 2025 Jan 25.Cancer Causes Control. 2025.PMID: 39862332 * [ Cardiovascular Disease Risk Among Older Asian, Native Hawaiian, Pacific Islanders Lung Cancer Survivors. ](https://pubmed.ncbi.nlm.nih.gov/39976397/) Pan Y, Chang CE, Tao R, Daud A, Shen J, Wong ND, Nianogo RA, Rao J, Varghese T, Zhang ZF, Hashibe M.Pan Y, et al.Cancer Med. 2025 Feb;14(4):e70702. doi: 10.1002/cam4.70702.Cancer Med. 2025.PMID: 39976397Free PMC article. * [ Racial Disparities in Head and Neck Cancer: It's Not Just About Access. ](https://pubmed.ncbi.nlm.nih.gov/38258967/) Whitehead RA, Patel EA, Liu JC, Bhayani MK.Whitehead RA, et al.Otolaryngol Head Neck Surg. 2024 Apr;170(4):1032-1044. doi: 10.1002/ohn.653. Epub 2024 Jan 23.Otolaryngol Head Neck Surg. 2024.PMID: 38258967 [ See all similar articles ](https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=42665904) ## References 1. 1. U.S. Cancer Statistics Working Group , U.S. Cancer Statistics Data Visualizations Tool, Based on 2021 Submission Data (1999–2019) (U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute, 2022). 2. 1. Kanaya A. M., Hsing A. W., Panapasa S. V., et al., “Knowledge Gaps, Challenges, and Opportunities in Health and Prevention Research for Asian Americans, Native Hawaiians, and Pacific Islanders: A Report From the 2021 National Institutes of Health Workshop,” Annals of Internal Medicine 175, no. 4 (2022): 574–589, 10.7326/M21-3729. - [DOI](https://doi.org/10.7326/m21-3729) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/PMC9018596/) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/34978851/) 3. 1. Eytan D. F., Blackford A. L., Eisele D. W., and Fakhry C., “Prevalence of Comorbidities Among Older Head and Neck Cancer Survivors in the United States,” Otolaryngology and Head and Neck Surgery 160, no. 1 (2019): 85–92, 10.1177/0194599818796163. - [DOI](https://doi.org/10.1177/0194599818796163) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/30252608/) 4. 1. Kwan T. W., Wong S. S., Hong Y., et al., “Epidemiolo
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