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APHA Scientific Session and Event Listing

Gopal K. Singh, PhD, Office of Data and Program Development, HRSA/Maternal and Child Health Bureau, 5600 Fishers Lane, Room 18-41, Rockville, MD 20857, 301-443-0765, gsingh@hrsa.gov and Robert A. Hiatt, MD, PhD, UCSF Comprehensive Cancer Center, University of California at San Francisco, Box 0981, San Francisco, CA 94143-0981.

Despite improvements over time in overall cancer survival and in early detection and treatment for several cancers, substantial racial and ethnic disparities in patient survival and disease stage continue to exist in the United States. Although the overall cancer survival rate for Asian and Pacific Islanders (API) as a group is favorable relative to the other ethnic groups, cancer survival and stage patterns differ for specific API subgroups. By fitting multivariate logistic and Cox regression models to the 1988-99 data from 11 population-based SEER cancer registries (N=1,663,844), we analyzed ethnic disparities in cancer survival and in the likelihood of late-stage breast, prostate, cervical, and colorectal cancers after adjusting for age at diagnosis, marital status, rural-urban residence, and neighborhood socioeconomic status (SES). Compared to non-Hispanic Whites, Chinese, Vietnamese, Koreans, Filipinos, and Hawaiians had respectively 22%, 47%, 54%, 4%, 40% higher overall cancer mortality risks, while Japanese and Asian Indians had 3% and 10% lower mortality. Adjusted racial/ethnic patterns in patient survival and in stage at diagnosis varied by cancer site. For example, even after controlling for individual sociodemographic and neighborhood characteristics, Chinese, Japanese, Filipinos, Asian Indians, Vietnamese, and Hawaiians were, respectively, at 54%, 22%, 82%, 72%, 85%, and 103% higher risks of distant-stage prostate cancer diagnoses and Asian Indians, Vietnamese, and Hawaiians were, respectively, at 47%, 71%, and 67% higher prostate cancer mortality risks than non-Hispanic Whites. SES and particularly stage at diagnosis accounted for much of the ethnic differentials in site-specific cancer survival, including those among API subgroups.

Learning Objectives:

• Describe ethnic disparities in overall cancer survival as well as in site-specific cancer survival and in stage at diagnosis, particularly among major Asian American and Pacific Islander subgroups .
• Learn about multivariate methods for analyzing ethnic and socioeconomic disparities in disease stage and patient survival using population-based cancer registry data.
• Identify API groups at risk for poor cancer outcomes and therefore in need for appropriate social, medical, and health care interventions.

Keywords: Asian and Pacific Islander, Cancer

Presenting author's disclosure statement:

Any relevant financial relationships? No