Colon Cancer Disparities in Stage at Presentation and Time to Surgery for Asian Americans, Native Hawaiians, and Pacific Islanders: A Study with Disaggregated Ethnic Groups
Name
10434_2023_13339_ReferencePDF.pdf
Size
1.12 MB
Format
Adobe PDF
Checksum (MD5)
94a29c8b0f36a1aeb46330841586a5f1
Author(s)
Jain, Bhav
Bajaj, Simar S.
Patel, Tej A.
Vapiwala, Neha
Lam, Miranda B.
Mahal, Brandon A.
Muralidhar, Vinayak
Amen, Troy B.
Nguyen, Paul L.
Sanford, Nina N.
Date Issued
April 5, 2023
Publisher
Springer International Publishing
Citation
Jain, Bhav, Bajaj, Simar S., Patel, Tej A., Vapiwala, Neha, Lam, Miranda B. et al. 2023. "Colon Cancer Disparities in Stage at Presentation and Time to Surgery for Asian Americans, Native Hawaiians, and Pacific Islanders: A Study with Disaggregated Ethnic Groups."
Version
Author's final manuscript
Abstract
Abstract
Background
Vast differences in barriers to care exist among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) groups and may manifest as disparities in stage at presentation and access to treatment. Thus, we characterized AANHPI patients with stage 0–IV colon cancer and examined differences in (1) stage at presentation and (2) time to surgery relative to white patients.
Patients and Methods
We assessed all patients in the National Cancer Database (NCDB) with stage 0–IV colon cancer from 2004 to 2016 who identified as white, Chinese, Japanese, Filipino, Native Hawaiian, Korean, Vietnamese, Laotian, Hmong, Kampuchean, Thai, Asian Indian or Pakistani, and Pacific Islander. Multivariable ordinal logistic regression defined adjusted odds ratios (AORs), with 95% confidence intervals (CI), of (1) patients presenting with advanced stage colon cancer and (2) patients with stage 0–III colon cancer receiving surgery at ≥ 60 days versus 30–59 days versus < 30 days postdiagnosis, adjusting for sociodemographic/clinical factors.
Results
Among 694,876 patients, Japanese [AOR 1.08 (95% CI 1.01–1.15), p < 0.05], Filipino [AOR 1.17 (95% CI 1.09–1.25), p < 0.001], Korean [AOR 1.09 (95% CI 1.01–1.18), p < 0.05], Laotian [AOR 1.51 (95% CI 1.17–1.95), p < 0.01], Kampuchean [AOR 1.33 (95% CI 1.04–1.70), p < 0.01], Thai [AOR 1.60 (95% CI 1.22–2.10), p = 0.001], and Pacific Islander [AOR 1.41 (95% CI 1.20–1.67), p < 0.001] patients were more likely to present with more advanced colon cancer compared with white patients. Chinese [AOR 1.27 (95% CI 1.17–1.38), p < 0.001], Japanese [AOR 1.23 (95% CI 1.10–1.37], p < 0.001], Filipino [AOR 1.36 (95% CI 1.22–1.52), p < 0.001], Korean [AOR 1.16 (95% CI 1.02–1.32), p < 0.05], and Vietnamese [AOR 1.55 (95% CI 1.36–1.77), p < 0.001] patients were more likely to experience greater time to surgery than white patients. Disparities persisted when comparing among AANHPI subgroups.
Conclusions
Our findings reveal key disparities in stage at presentation and time to surgery by race/ethnicity among AANHPI subgroups. Heterogeneity upon disaggregation underscores the importance of examining and addressing access barriers and clinical disparities.
Terms of Use
Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use.
Persistent DSpace Link
DOI of Published Version
https://doi.org/10.1245/s10434-023-13339-0
