Journal article
Cancer-specific mortality of Asian Americans diagnosed with cancer: a nationwide population-based assessment
JNCI : Journal of the National Cancer Institute, Vol.107(6), pp.djv054-djv054
06/01/2015
DOI: 10.1093/jnci/djv054
PMID: 25794888
Abstract
Racial disparities in cancer survival outcomes have been primarily attributed to underlying biologic mechanisms and the quality of cancer care received. Because prior literature shows little difference exists in the socioeconomic status of non-Hispanic whites and Asian Americans, any difference in cancer survival is less likely to be attributable to inequalities of care. We sought to examine differences in cancer-specific survival between whites and Asian Americans.
The Surveillance, Epidemiology, and End Results Program was used to identify patients with lung (n = 130 852 [16.9%]), breast (n = 313 977 [40.4%]), prostate (n = 166 529 [21.4%]), or colorectal (n = 165 140 [21.3%]) cancer (the three leading causes of cancer-related mortality within each sex) diagnosed between 1991 and 2007. Fine and Gray's competing risks regression compared the cancer-specific mortality (CSM) of eight Asian American groups (Chinese, Filipino, Hawaiian/Pacific Islander, Japanese, Korean, other Asian, South Asian [Indian/Pakistani], and Vietnamese) to non-Hispanic white patients. All P values were two-sided.
In competing risks regression, the receipt of definitive treatment was an independent predictor of CSM (hazard ratio [HR] = 0.37, 95% confidence interval [CI] = 0.35 to 0.40; HR = 0.55, 95% CI = 0.53 to 0.58; HR = 0.61, 95% CI = 0.60 to 0.62; and HR = 0.27, 95% CI = 0.25 to 0.29) for prostate, breast, lung, and colorectal cancers respectively, all P < .001). In adjusted analyses, most Asian subgroups (except Hawaiians and Koreans) had lower CSM relative to white patients, with hazard ratios ranging from 0.54 (95% CI = 0.38 to 0.78) to 0.88 (95% CI = 0.84 to 0.93) for Japanese patients with prostate and Chinese patients with lung cancer, respectively.
Despite adjustment for potential confounders, including the receipt of definitive treatment and tumor characteristics, most Asian subgroups had better CSM than non-Hispanic white patients. These findings suggest that underlying genetic/biological differences, along with potential cultural variations, may impact survival in Asian American cancer patients.
Details
- Title: Subtitle
- Cancer-specific mortality of Asian Americans diagnosed with cancer: a nationwide population-based assessment
- Creators
- Quoc-Dien Trinh - Brigham and Women's HospitalPaul L NguyenJeffrey J Leow - Dana-Farber Brigham Cancer CenterDeepansh Dalela - Dana-Farber Brigham Cancer CenterGrace F Chao - Harvard UniversityBrandon A Mahal - Dana-Farber Brigham Cancer CenterManan Nayak - Harvard UniversityMarianne Schmid - Brigham and Women's HospitalToni K Choueiri - Brigham and Women's HospitalAyal A Aizer - Brigham and Women's Hospital
- Resource Type
- Journal article
- Publication Details
- JNCI : Journal of the National Cancer Institute, Vol.107(6), pp.djv054-djv054
- DOI
- 10.1093/jnci/djv054
- PMID
- 25794888
- NLM abbreviation
- J Natl Cancer Inst
- ISSN
- 0027-8874
- eISSN
- 1460-2105
- Language
- English
- Date published
- 06/01/2015
- Academic Unit
- Urology
- Record Identifier
- 9984949188302771
Metrics
4 Record Views