Survival differences among Asian subpopulations in the United States after prostate, colorectal, breast, and cervical carcinomas

Abstract

BACKGROUNDInformation is limited for Asian subgroups regarding survival after diagnosis of the common cancers amenable to routine screening. The authors examined survival after carcinomas of the prostate, colon/rectum, breast, and cervix separately for Chinese, Japanese, Filipinos, and non‐Hispanic whites in the United States.METHODSUsing data from the Surveillance, Epidemiology, and End Results program, the authors compared the distributions of stage at diagnosis and computed 5‐year cause specific survival probabilities, overall and by stage of disease, for cancer patients whose diagnosis was in 1988–1994 and who were observed through 1997.RESULTSAmong males, Filipinos were more likely to be diagnosed with advanced stage colorectal and prostate carcinomas than other Asians and non‐Hispanic whites; they also experienced worse survival after these cancers. This survival deficit occurred across all stages of colorectal carcinoma and remained apparent within distant stage prostate carcinoma. Among females, Chinese were less likely to receive diagnoses of early stage colorectal carcinoma than Japanese and Filipinas. In addition, their survival was consistently lower across more advanced stages of disease. Chinese also experienced somewhat worse survival after diagnosis of early stage cervical carcinoma. Japanese were more likely to be diagnosed with early stage carcinomas but also tended to experience better survival after prostate, colorectal, and breast carcinomas regardless of stage.CONCLUSIONSChinese, Japanese, and Filipinos experienced unequal survival after these screenable carcinomas, indicating that certain groups may benefit from more aggressive screening efforts. The heterogeneity of cancer outcomes observed within the community classified as Asian reinforces the need for cancer statistics to be reported for disaggregated subgroups. Cancer 2002;94:1175–82. © 2002 American Cancer Society.DOI 10.1002/cncr.10319

Cancer survival discrepancies in developed and developing countries: comparisons between the Philippines and the United States

“…These results are consistent with those of earlier studies mostly focusing on single forms of cancers (Flood et al, 2000;Pineda et al, 2001;Lin et al, 2002;McGuire et al, 2002;Hashibe et al, 2003;Pagano et al, 2003;Chien et al, 2005;Gomez et al, 2007;Sun et al, 2007). Existing differences probably lie more in biological factors than health care-related factors.…”

Socioeconomic status and breast carcinoma survival in four racial/ethnic groups

“…29 A SEER-wide study of breast carcinoma diagnosed in females in the 1988 -1994 period found higher stage-adjusted survival rates for Japanese females than for Chinese, Filipinas, or whites. 18 A previous study of breast carcinoma survival in the San Francisco Bay Area showed that for women diagnosed with local disease, Filipinas had significantly lower relative survival than whites. 17 By combining all APIs into one category, we may have obscured the higher survival of the Japanese with the lower survival of the Filipinas.…”

“…9,[12][13][14][15] International studies of breast carcinoma have shown better survival for Japanese than Caucasians, 16 but most studies report similar survival rates for Asians and whites within the United States. 12,[17][18][19] In addition, although race/ethnicity, disease stage, and SES are correlated, SES measures have not been included in most studies of Asian and Hispanic women. Previous studies of survival by race/ ethnicity were limited by the lack of data on SES and tumor characteristics, inclusion of in situ disease with local stage disease, and inadequate statistical power due to small sample sizes.…”

Racial and ethnic differences in breast cancer survival

“…45,46 Future analyses should disaggregate the R/E categories so that we can better understand these findings. 11,44 The use of aggregate-based measures to assign individual SES status is suboptimal. 20 However, aggregate measures of income at the community level remains valuable because community-level predictors of SES have been shown to be a strong predictor of healthcare services and health outcomes for all individuals living in that community (both high and low income).…”

“…Possible explanations include differences in screening mammography leading to differences in the stage and size of tumors at diagnosis, 5,6 tumor biology, inadequate receipt of appropriate breast cancer treatment, 5 and underlying patient comorbidities and socioeconomic factors. [7][8][9][10][11] Several studies have used Surveillance, Epidemiology, and End Results (SEER) program information to explore these issues. 3,4,[12][13][14][15][16][17][18] Although SEER data include valuable regional information on a large, geographically diverse population, it lacks detailed information concerning screening mammography use and underlying comorbidities that may impact survival.…”