The 130th Annual Meeting of APHA

Abstract #43310

J.H. Choe, MD¹, T.D. Koepsell, MD, MPH¹, and P.J. Heagerty, PhD². (1) Robert Wood Johnson Clinical Scholars Program, University of Washington, H220 Health Sciences Center, Box 357183, Seattle, WA 98195, (206) 616-8724, johnchoe@u.washington.edu, (2) Department of Biostatistics, University of Washington, F-667 Health Sciences Center, Seattle, WA 98195

BACKGROUND: Asian Americans and Pacific Islanders (AAPI) have more favorable survival following diagnosis of colorectal cancer than other populations. However, foreign-born immigrants face many challenges that may place them at risk for worse health outcomes. Our purpose was to compare 5-year survival between foreign-born and U.S.-born AAPIs after diagnosis with colorectal cancer.

METHODS: We identified 10,985 AAPI patients with colorectal cancer diagnosed between 1973 and 1993 from the SEER database, a dynamic population-based cancer registry. Patients were categorized as foreign-born or U.S.-born, with missing information assigned utilizing multiple imputation methods. The outcome was death within 5 years of diagnosis of colorectal cancer. We used multivariate logistic regression to estimate the increased risk of death associated with foreign birth.

RESULTS: Among AAPI patients, foreign birth was associated with significantly higher risk for death within 5 years of diagnosis of colorectal cancer (unadjusted odds ratio 1.44; 95% confidence interval 1.32-1.58). Foreign birth was associated with higher risk for death even after adjustment for age, diagnosis year, gender, marital status, and ethnic group (OR 1.18; 95% CI 1.04-1.33). Only after additional adjustment for stage at presentation does this increased risk for foreign birth become nonsignificant (OR 1.12; 95% CI 0.97-1.29).

CONCLUSION: Foreign-born Asian American and Pacific Islander immigrants remain a group at increased risk for death following diagnosis of colorectal cancer. Much of this difference appears to be related to later stage at diagnosis among the foreign-born. Identifying strategies to increase screening among this vulnerable population may help reduce the disparity in survival.

Learning Objectives:

• At the conclusion of this presentation, the learner should be able to quantify some of the increased risk associated with foreign-birth among Asian Americans and Pacific Islanders with colorectal cancer, as well as understand some of the potential causes.

Keywords: Asian and Pacific Islander, Mortality

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.