Prostate Cancer Disparities in Risk Group at Presentation and Access to Treatment for Asian Americans, Native Hawaiians, and Pacific Islanders: A Study With Disaggregated Ethnic Groups

Jain, Bhav; Ng, Kenrick; Santos, Patricia Mae G.; Taparra, Kekoa; Muralidhar, Vinayak; Mahal, Brandon A.; Vapiwala, Neha; Trinh, Quoc‐Dien; Nguyen, Paul L.; Dee, Edward Christopher

doi:10.1200/op.21.00412

Cited by 29 publications

(28 citation statements)

References 48 publications

(69 reference statements)

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“…Compared to other Asian groups, Filipinxs also have higher prevalence of hypertension compared with non-Hispanic white. Filipinx also had the highest incidence rates of prostate cancer and thyroid cancer, and the highest mortality rates for breast cancer, prostate cancer and thyroid cancer among the largest Asian groups in California (5) but most cancer research continue to report findings in the aggregate (6,7). These health disparities persist even among Filipinxs who score well on socioeconomic measures that are often associated with better health outcomes (i.e., employment, education, English language proficiency), which suggests the need to expand these traditional measures to include indicators of structural racism that result to entrenched inequities (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Lost on the frontline, and lost in the data: COVID-19 deaths among Filipinx healthcare workers in the United States

Escobedo¹,

Morey

Sabado-Liwag

et al. 2022

Front. Public Health

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BackgroundFilipinx Americans working in healthcare are at risk for COVID-19 death but lack consistent mortality data on healthcare worker deaths. The lack of disaggregated data for Asian subgroups proliferates anti-Asian structural racism as the needs of high-risk groups are systematically undetected to merit a proper public health response. We work around this aggregated data problem by examining how the overrepresentation of Filipinxs in healthcare contributes to COVID-19 mortality among Asian American populations.MethodsTo overcome the lack of COVID-19 mortality data among Filipinx American healthcare workers, we merged data from several sources: Kanlungan website (the only known public-facing source of systematically reported mortality data on Filipinx healthcare workers nationally and globally), National Center for Health Statistics, and 2014–2018 American Community Survey. We examined county-level associations using t-tests, scatterplots, and linear regression.FindingsA higher percentage of Filipinxs among Asian Americans was correlated with a higher percentage of COVID-19 decedents who are Asian Americans (r = 0.24, p = 0.01). The percentage of Filipinx in healthcare remained a strong predictor of COVID-19 deaths among Asian Americans even after adjusting for age, poverty, and population density (coef = 1.0, p < 0.001). For every 1% increase in Filipinx among the healthcare workforce, the percentage of Asian American COVID-19 decedents increased by 1%.InterpretationOur study shows that the overrepresentation of Filipinxs in healthcare contributes to COVID-19 mortality disparities among Asian Americans. Our findings advocate for systems change by practicing anti-racist data agendas that collect and report on Asian subgroups for effective real-time targeted approaches against health inequities.

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Section: Introductionmentioning

confidence: 99%

Lost on the frontline, and lost in the data: COVID-19 deaths among Filipinx healthcare workers in the United States

Escobedo¹,

Morey

Sabado-Liwag

et al. 2022

Front. Public Health

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“…In addition to genomic and environmental contributors, social determinants of health likely play critical role in mediating these disparities. Language barriers and health literacy likely influence these outcomes in Asian American populations, which represent one of the largest limited English proficient populations 13,18 . Because of their linguistic diversity, levels of English proficiency are diverse among AANHPI groups.…”

Section: Discussionmentioning

confidence: 99%

“…Language barriers and health literacy likely influence these outcomes in Asian American populations, which represent one of the largest limited English proficient populations. 13,18 Because of their linguistic diversity, levels of English proficiency are diverse among AANHPI groups. For instance, previous studies have reported that Vietnamese, Chinese, and Korean were more highly disfluent than other ethnic groups.…”

Section: Discussionmentioning

confidence: 99%

“…Because of the relatively small sample size, patients who identified as Micronesian, Chamorro, Guamanian, Polynesian, Tahitian, Samoan, Tongan, Melanesian, Fiji Islander, and New Guinean were included in Pacific Islander as a single cohort. 13 Stage is entered into the NCDB using the American Joint Committee on Cancer (AJCC) Cancer Staging Manual edition that was in use at the time of diagnosis. 14 For those who did not have data on treatment status, they were included in the "unknown treatment" strata.…”

Section: Methodsmentioning

confidence: 99%

“…Patients were disaggregated by race and ethnicity: White, Chinese, Japanese, Filipino, Hawaiian, Korean, Vietnamese, Laotian, Hmong, Kampuchean, Thai, Asian Indian, Pakistani, Pacific Islander, and other regardless of Hispanic ethnicity. Because of the relatively small sample size, patients who identified as Micronesian, Chamorro, Guamanian, Polynesian, Tahitian, Samoan, Tongan, Melanesian, Fiji Islander, and New Guinean were included in Pacific Islander as a single cohort 13 . Stage is entered into the NCDB using the American Joint Committee on Cancer (AJCC) Cancer Staging Manual edition that was in use at the time of diagnosis 14 .…”

Section: Methodsmentioning

confidence: 99%

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Non‐small cell lung cancer disparities in stage at presentation and treatment for Asian American, Native Hawaiian, and Pacific Islander women

Hong

Swami

Dee

et al. 2023

Journal of Surgical Oncology

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Background and Objectives Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) represent the fastest‐growing group in the United States. While described in aggregate, great variations exist within the community. We aimed to determine whether there were differences in stage at presentation and treatment status among AANHPI women with non‐small cell lung cancer (NSCLC). Methods Between 2004 and 2016, we identified 522 361 female patients with newly diagnosed NSCLC from the National Cancer Database. Multivariable logistic regression models were used to define adjusted odds ratios (aORs) of presenting with stage IV disease and not receiving treatment. Results AANHPI women were more likely to present with stage IV disease compared to White (54.32% vs. 40.28%, p < 0.001). Aside from Hawaiian, Pakistani, and Hmong women, all other ethnic groups had greater odds of presenting with stage IV disease than White women. AANHPI women <65 years were more likely to present with stage IV disease (p = 0.030). Only Vietnamese women showed a significant difference (aOR = 1.30 [1.06–1.58], p = 0.010) for likelihood of receiving treatment compared to White. Conclusions Differences in stage at presentation and treatment status in women with NSCLC were observed among AANHPI ethnic groups when populations were disaggregated.

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Region of origin and cervical cancer stage in multiethnic Hispanic/Latinx patients living in the United States

Dinicu,

Dioun,

Goldberg

et al. 2023

Cancer Medicine

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BackgroundHispanic/Latinx people have the second highest cervical cancer incidence rates in the U.S. However, there is a lack of disaggregated data on clinical outcomes for this diverse and populous group, which is critical to direct resources and funding where they are most needed. This study assessed differences in stage at diagnosis of cervical cancer among Hispanic/Latinx subpopulations and associated factors.MethodsWe analyzed patients with primary cervical cancer from 2004 to 2019 in the National Cancer Database. Hispanic/Latinx patients were further categorized into Mexican, Puerto Rican (PR), Cuban, Dominican, and Central/South American, as per standard NCDB categories, and evaluated based on stage at diagnosis and sociodemographic characteristics. Multinomial logistic regression quantified the odds of advanced stage at presentation. Regression models were adjusted for age, education, neighborhood income, insurance status, and additional factors.ResultsHispanic/Latinx cervical cancer patients were more likely to be uninsured (18.9% vs. 6.0%, p < 0.001) and more likely to live in low‐income neighborhoods (28.6% vs. 16.9%, p < 0.001) when compared to non‐Hispanic White populations. Uninsured Hispanic/Latinx patients had 37.0% higher odds of presenting with regional versus localized disease (OR 1.37; 95% CI, 1.19–1.58) and 47.0% higher odds of presenting with distant versus. Localized disease than insured patients (OR 1.47; 95% CI, 1.33–1.62). When adjusting for age, education, neighborhood income, and insurance status, PR patients were 48% more likely than Mexican patients to present with stage IV versus stage I disease (OR 1.48; 95% CI, 1.34–1.64).ConclusionDisaggregating health data revealed differences in stage at cervical cancer presentation among Hispanic/Latinx subpopulations, with insurance status as a major predictor. Further work targeting structural factors, such as insurance status, within specific Hispanic/Latinx subpopulations is needed.

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Prostate Cancer Disparities in Risk Group at Presentation and Access to Treatment for Asian Americans, Native Hawaiians, and Pacific Islanders: A Study With Disaggregated Ethnic Groups

Cited by 29 publications

References 48 publications

Lost on the frontline, and lost in the data: COVID-19 deaths among Filipinx healthcare workers in the United States

Lost on the frontline, and lost in the data: COVID-19 deaths among Filipinx healthcare workers in the United States

Non‐small cell lung cancer disparities in stage at presentation and treatment for Asian American, Native Hawaiian, and Pacific Islander women

Region of origin and cervical cancer stage in multiethnic Hispanic/Latinx patients living in the United States

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