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Background <p>Cancer survivors with diabetes require routine, high-quality care to prevent complications and support positive health outcomes. Racial and ethnic disparities in diabetes care may contribute to differences in disease management. This study examined disparities in diabetes management among cancer survivors and the role of patient-provider communication (PPC) in addressing these gaps.</p> Methods <p>We conducted a retrospective cross-sectional analysis using 2008–2021 Medical Expenditure Panel Survey data. The study population included diabetic cancer survivors who self-reported PPC quality and diabetes care utilization. The primary exposure was excellent vs. less than excellent PPC, and outcomes included adherence to diabetes management guidelines, defined as receiving ≥ 2 HbA1c tests, an annual foot exam, and an annual eye exam.</p> Results <p>Stratified analyses revealed significant variation in the association between excellent PPC and receipt of guideline-concordant care. Among Hispanic patients, excellent PPC was associated with higher odds of receiving ≥ 2 HbA1c tests (OR: 2.62, 95% CI: 2.25–2.70), foot exams (OR: 1.65, 95% CI: 1.59–1.70), and eye exams (OR: 1.12, 95% CI: 1.08–1.16). Asian patients with excellent PPC also had higher odds of ≥ 2 HbA1c tests (OR: 4.97, 95% CI: 4.59–5.37) and an annual foot exam (OR: 1.60, 95% CI: 1.50–1.70). In contrast, Non-Hispanic Black patients with excellent PPC were significantly less likely to receive all three diabetes screenings compared to those with not excellent PPC. Among Non-Hispanic White survivors, excellent PPC was associated with modestly higher odds of foot and eye exams.</p> Conclusion <p>Among cancer survivors with diabetes, the impact of excellent PPC on diabetes management varied by race and ethnicity. While excellent PPC was associated with improved screening among Hispanic and Asian survivors, it was associated with lower odds of diabetes management among Non-Hispanic Black survivors. These findings suggest additional systemic factors may contribute to the inverse association observed for Black cancer survivors.</p>

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Excellent Patient-Provider Communication May Mitigate Racial and Ethnic Disparities in Diabetes Care Management Among Cancer Survivors

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月14日

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  • Miriam L. Gorbatov,
  • Claudia Rodriguez,
  • Sarah D. Gorbatov,
  • Albert J. Farias

摘要

Background

Cancer survivors with diabetes require routine, high-quality care to prevent complications and support positive health outcomes. Racial and ethnic disparities in diabetes care may contribute to differences in disease management. This study examined disparities in diabetes management among cancer survivors and the role of patient-provider communication (PPC) in addressing these gaps.

Methods

We conducted a retrospective cross-sectional analysis using 2008–2021 Medical Expenditure Panel Survey data. The study population included diabetic cancer survivors who self-reported PPC quality and diabetes care utilization. The primary exposure was excellent vs. less than excellent PPC, and outcomes included adherence to diabetes management guidelines, defined as receiving ≥ 2 HbA1c tests, an annual foot exam, and an annual eye exam.

Results

Stratified analyses revealed significant variation in the association between excellent PPC and receipt of guideline-concordant care. Among Hispanic patients, excellent PPC was associated with higher odds of receiving ≥ 2 HbA1c tests (OR: 2.62, 95% CI: 2.25–2.70), foot exams (OR: 1.65, 95% CI: 1.59–1.70), and eye exams (OR: 1.12, 95% CI: 1.08–1.16). Asian patients with excellent PPC also had higher odds of ≥ 2 HbA1c tests (OR: 4.97, 95% CI: 4.59–5.37) and an annual foot exam (OR: 1.60, 95% CI: 1.50–1.70). In contrast, Non-Hispanic Black patients with excellent PPC were significantly less likely to receive all three diabetes screenings compared to those with not excellent PPC. Among Non-Hispanic White survivors, excellent PPC was associated with modestly higher odds of foot and eye exams.

Conclusion

Among cancer survivors with diabetes, the impact of excellent PPC on diabetes management varied by race and ethnicity. While excellent PPC was associated with improved screening among Hispanic and Asian survivors, it was associated with lower odds of diabetes management among Non-Hispanic Black survivors. These findings suggest additional systemic factors may contribute to the inverse association observed for Black cancer survivors.