2273-P: Associations between Diabetes Complications and Prostate and Colon Cancers: A 2-, 5-, and 10-Year Comparison Analysis

Introduction and Objective: Beyond treatment-related cardiotoxicity, very few studies examine the cardiometabolic risk among patients with type 2 diabetes mellitus (T2DM) after a cancer diagnosis. The objective of this study was to determine whether non-metastatic prostate cancer, compared to non-metastatic colon cancer, is associated with differential incidence and timing of cardiovascular complications in adults with T2DM and no baseline diabetic complications. Methods: We conducted a retrospective, propensity score-matched cohort study using the TriNetX US Collaborative Research Network. Male adults ≥18 years with T2DM and either non-metastatic prostate cancer or non-metastatic colon cancer were included. Cohorts were 1:1 propensity score matched based on demographics, medications, HbA1c, baseline eGFR, and comorbidities. Outcomes included heart failure (HF), myocardial infarction (MI), peripheral vascular disease (PVD), and all-cause mortality assessed at 2-, 5-, and 10-year follow-up intervals using Cox proportional hazard models (HR) with 95% confidence intervals (CI). Results: Propensity score matching yielded 5097 patients per cohort. Compared to colon cancer, prostate cancer was associated with significantly lower cardiometabolic risk. At 2 years, prostate cancer demonstrated lower HF (HR=0.708, 95% CI 0.600-0.836, p<0.0001) and mortality (HR=0.625, 95% CI 0.553-0.706, p<0.0001). At 5 years, prostate cancer demonstrated lower PVD risk (HR=0.839, 95% CI 0.712-0.987, p=0.034) and remained lower at 10 years. No significant associations with MI were observed. Conclusion: In this real-world cohort of adults with T2DM, colon cancer was associated with substantially higher cardiometabolic risk and mortality, compared with prostate cancer. These differences highlight the importance of longitudinal risk characterization in future research. Disclosure H. Chan: None. M. Dao: None. S.Y. Zhao: None. C. Xie: None. U. Phatak: None. C.J. Garza: None. W. Lee: None.