Data from Impact of Comorbidities on Survival among American Indian and Alaska Native People with Cancer: A Surveillance, Epidemiology, and End Results–Medicare Study

<jats:p>&lt;div&gt;Abstract Background:&lt;p&gt;American Indian and Alaska Native (AIAN) people experience lower cancer survival than other racial/ethnic groups for several cancer sites. We explored predictors of cancer survival among AIAN people, with a specific focus on the potential impact of comorbidities.&lt;/p&gt; Methods:&lt;p&gt;We analyzed the Surveillance, Epidemiology, and End Results–Medicare linked database. AIAN people diagnosed with breast (female only), lung, and colorectal cancers from 2000 to 2019, ages 66+ years at diagnosis, and with at least 1 year of Medicare coverage prior to diagnosis were included in the study. We used multivariable-adjusted Cox proportional hazards models to assess associations of comorbidity class, previously defined using latent class analysis, with overall and cancer-specific survival, adjusted for sociodemographic characteristics and area-based social measures.&lt;/p&gt; Results:&lt;p&gt;The sample included 831 individuals with female breast cancer, 1,009 individuals with colorectal cancer, and 1,195 individuals with lung cancer. Comorbidity class was associated with 5-year hazard of death from any cause for patients with breast and colorectal cancers but not patients with lung cancer. Furthermore, we only observed associations of comorbidity class with 5-year cancer-specific death for lung cancer, in which the class associated with heart and vascular-related conditions experienced increased hazard of death.&lt;/p&gt; Conclusions:&lt;p&gt;Higher comorbidity prevalence among AIAN people compared with other racial/ethnic groups did not contribute to observed disparities in cancer-specific survival; however, AIAN people with comorbid conditions may be more likely to experience death from any cause than those without these conditions.&lt;/p&gt; Impact:&lt;p&gt;Differences in prevalence of comorbid conditions are unlikely to drive disparities in cancer-specific survival observed among AIAN people.&lt;/p&gt;&lt;/div&gt;</jats:p>