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Noel CW, Sutradhar R, Li Q, Forner D, Hallet J, Cheung M, Singh S, Coburn NG, Eskander A. Chinese and South Asian ethnicity, immigration status and head and neck cancer outcomes: A population based study. Oral Oncol 2020; 113:105118. [PMID: 33341005 DOI: 10.1016/j.oraloncology.2020.105118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 01/29/2023]
Abstract
OBJECTIVE While it is known that certain ethnic and immigrant groups are at increased risk of developing head and neck cancer, the individual effects of immigration status and ethnicity on head and neck cancer outcomes is less clear. We sought examine the independent effects of immigration and Chinese and South Asian ethnicity on overall survival in a head and neck cancer patient population. METHODS This was a population-based retrospective matched cohort study using linked Ontario administrative databases between 1994 and 2017. Incident cancer cases were captured in long-standing residents of Chinese and South Asian ethnicity, Chinese and South Asian immigrants, as well as a reference population. Subjects were followed until death. A hard-matching approach was used to adjust for key differences and ensure both groups were balanced with respect to age, sex and cancer site. Cox proportional hazard models were used to estimate the impact of Chinese and South Asian ethnicity on overall survival while further adjusting for baseline covariates. RESULTS Among 1639 immigrants with head and neck cancer, matched to 3278 controls, the overall 5-year survival rate was 66% and 59%, respectively. After adjusting for between group-differences, all-cause mortality was lower for immigrants (HR 0.76[95%CI 0.69-0.83]) and individuals of Chinese ethnicity (HR 0.78[95%CI 0.68-0.90]), relative to the general population. CONCLUSIONS In Ontario, immigrants experience lower mortality rates following a head and neck cancer diagnosis. Individuals of Chinese ethnicity with head and neck cancer experience a survival advantage, relative to South Asian individuals and the general population.
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Affiliation(s)
- Christopher W Noel
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Institute for Clinical and Evaluative Sciences, Canada
| | - Rinku Sutradhar
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Institute for Clinical and Evaluative Sciences, Canada
| | - Qing Li
- Institute for Clinical and Evaluative Sciences, Canada
| | - David Forner
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Division of Otolaryngology - Head and Neck Surgery, Dalhousie University, Halifax, Canada
| | - Julie Hallet
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Institute for Clinical and Evaluative Sciences, Canada; Department of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Matthew Cheung
- Department of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Simron Singh
- Department of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Natalie G Coburn
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Institute for Clinical and Evaluative Sciences, Canada; Department of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Institute for Clinical and Evaluative Sciences, Canada; Department of Surgical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.
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Lao C, Lawrenson R, Edwards M, Campbell I. Treatment and survival of Asian women diagnosed with breast cancer in New Zealand. Breast Cancer Res Treat 2019; 177:497-505. [DOI: 10.1007/s10549-019-05310-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 05/29/2019] [Indexed: 12/24/2022]
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Pollard J, Burns P, Hughes T, Ho-Yen C, Jones J, Mukherjee G, Omoniyi-Esan G, Titloye N, Speirs V, Shaaban A. Differential Expression of MicroRNAs in Breast Cancers from Four Different Ethnicities. Pathobiology 2018; 85:220-226. [DOI: 10.1159/000488456] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 03/11/2018] [Indexed: 01/05/2023] Open
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Stevenson JK, Cheung MC, Earle CC, Fischer HD, Camacho X, Saskin R, Shah BR, Austin PC, Singh S. Chinese and South Asian ethnicity, immigration status, and clinical cancer outcomes in the Ontario Cancer System. Cancer 2018; 124:1473-1482. [DOI: 10.1002/cncr.31231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 12/13/2017] [Accepted: 12/19/2017] [Indexed: 01/01/2023]
Affiliation(s)
| | - Matthew C. Cheung
- Division of Hematology, Department of Medicine; University of Toronto; Toronto Ontario Canada
- Odette Cancer Centre; Sunnybrook Health Sciences Centre; Toronto Ontario Canada
| | - Craig C. Earle
- Department of Medicine; University of Toronto; Toronto Ontario Canada
- Odette Cancer Centre; Sunnybrook Health Sciences Centre; Toronto Ontario Canada
- Ontario Institute for Cancer Research; Toronto Ontario Canada
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
| | - Hadas D. Fischer
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
| | - Ximena Camacho
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
| | - Refik Saskin
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
| | - Baiju R. Shah
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
- Division of Endocrinology, Department of Medicine; University of Toronto; Toronto Ontario Canada
| | - Peter C. Austin
- Institute for Clinical Evaluative Sciences; Toronto Ontario Canada
- Institute for Health Policy, Management and Evaluation; University of Toronto; Toronto Ontario Canada
| | - Simron Singh
- Odette Cancer Centre; Sunnybrook Health Sciences Centre; Toronto Ontario Canada
- Division of Medical Oncology, Department of Medicine; University of Toronto; Toronto Ontario Canada
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Stewart SL, Kwong SL, Bowlus CL, Nguyen TT, Maxwell AE, Bastani R, Chak EW, Chen Jr MS. Racial/ethnic disparities in hepatocellular carcinoma treatment and survival in California, 1988-2012. World J Gastroenterol 2016; 22:8584-8595. [PMID: 27784971 PMCID: PMC5064040 DOI: 10.3748/wjg.v22.i38.8584] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 08/16/2016] [Accepted: 09/12/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To describe racial/ethnic differences in treatment and survival among liver cancer patients in a population-based cancer registry.
METHODS Invasive cases of primary hepatocellular carcinoma, n = 33270, diagnosed between January 1, 1988-December 31, 2012 and reported to the California Cancer Registry were analyzed by race/ethnicity, age, gender, geographical region, socio-economic status, time period of diagnosis, stage, surgical treatment, and survival. Patients were classified into 15 racial/ethnic groups: non-Hispanic White (White, n = 12710), Hispanic (n = 8500), Chinese (n = 2723), non-Hispanic Black (Black, n = 2609), Vietnamese (n = 2063), Filipino (n = 1479), Korean (n = 1099), Japanese (n = 658), American Indian/Alaskan Native (AIAN, n = 281), Laotian/Hmong (n = 244), Cambodian (n = 233), South Asian (n = 190), Hawai`ian/Pacific Islander (n = 172), Thai (n = 95), and Other Asian (n = 214). The main outcome measures were receipt of surgical treatment, and cause-specific and all-cause mortality.
RESULTS After adjustment for socio-demographic characteristics, time period, and stage of disease, compared to Whites, Laotian/Hmong [odds ratio (OR) = 0.30, 95%CI: 0.17-0.53], Cambodian (OR = 0.65, 95%CI: 0.45-0.96), AIAN (OR = 0.66, 95%CI: 0.46-0.93), Black (OR = 0.76, 95%CI: 0.67-0.86), and Hispanic (OR = 0.78, 95%CI: 0.72-0.84) patients were less likely, whereas Chinese (OR = 1.58, 95%CI: 1.42-1.77), Koreans (OR = 1.45, 95%CI: 1.24-1.70), Japanese (OR = 1.41, 95%CI: 1.15-1.72), and Vietnamese (OR = 1.26, 95%CI: 1.12-1.42) were more likely to receive surgical treatment. After adjustment for the same covariates and treatment, cause-specific mortality was higher for Laotian/Hmong [(hazard ratio (HR) = 1.50, 95%CI: 1.29-1.73)], Cambodians (HR = 1.35, 95%CI: 1.16-1.58), and Blacks (HR = 1.07, 95%CI: 1.01-1.13), and lower for Chinese (HR = 0.82, 95%CI: 0.77-0.86), Filipinos (HR = 0.84, 95%CI: 0.78-0.90), Vietnamese (HR = 0.85, 95%CI: 0.80-0.90), Koreans (HR = 0.90, 95%CI: 0.83-0.97), and Hispanics (HR = 0.91, 95%CI: 0.88-0.94); results were similar for all-cause mortality.
CONCLUSION Disaggregated data revealed substantial racial/ethnic differences in liver cancer treatment and survival, demonstrating the need for development of targeted interventions to mitigate disparities.
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Chao GF, Krishna N, Aizer AA, Dalela D, Hanske J, Li H, Meyer CP, Kim SP, Mahal BA, Reznor G, Schmid M, Choueiri TK, Nguyen PL, O'Leary M, Trinh QD. Asian Americans and prostate cancer: A nationwide population-based analysis. Urol Oncol 2016; 34:233.e7-15. [DOI: 10.1016/j.urolonc.2015.11.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 09/02/2015] [Accepted: 11/14/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Grace F Chao
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Nandita Krishna
- Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA
| | - Ayal A Aizer
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA
| | - Deepansh Dalela
- Center for Outcomes Research, Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI
| | - Julian Hanske
- Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA
| | - Hanhan Li
- Center for Outcomes Research, Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI
| | - Christian P Meyer
- Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA
| | - Simon P Kim
- Urology Institute, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH
| | | | - Gally Reznor
- Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA
| | - Marianne Schmid
- Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA
| | - Toni K Choueiri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Paul L Nguyen
- Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA
| | - Michael O'Leary
- Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA
| | - Quoc-Dien Trinh
- Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA.
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The Influence of Socioeconomic Status on Racial/Ethnic Disparities among the ER/PR/HER2 Breast Cancer Subtypes. J Cancer Epidemiol 2015; 2015:813456. [PMID: 26339244 PMCID: PMC4539118 DOI: 10.1155/2015/813456] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 06/30/2015] [Accepted: 07/08/2015] [Indexed: 01/10/2023] Open
Abstract
Background. The eight ER/PR/HER2 breast cancer subtypes vary widely in demographic and clinicopathologic characteristics and survival. This study assesses the contribution of SES to the risk of mortality for blacks, Hispanics, Asian/Pacific Islanders, and American Indians when compared with white women for each ER/PR/HER2 subtype. Methods. We identified 143,184 cases of first primary female invasive breast cancer from the California Cancer Registry between 2000 and 2012. The risk of mortality was computed for each race/ethnicity within each ER/PR/HER2 subtype. Models were adjusted for tumor grade, year of diagnosis, and age. SES was added to a second set of models. Analyses were conducted separately for each stage. Results. Race/ethnicity did not contribute to the risk of mortality for any subtype in stage 1 when adjusted for SES. In stages 2, 3, and 4, race/ethnicity was associated with risk of mortality and adjustment for SES changed the risk only in some subtypes. SES reduced the risk of mortality by over 45% for American Indians with stage 2 ER+/PR+/HER2− cancer, but it decreased the risk of mortality for blacks with stage 2 triple negative cancer by less than 4%. Conclusions. Racial/ethnic disparities do not exist in all ER/PR/HER2 subtypes and, in general, SES modestly alters these disparities.
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Maringe C, Li R, Mangtani P, Coleman MP, Rachet B. Cancer survival differences between South Asians and non-South Asians of England in 1986-2004, accounting for age at diagnosis and deprivation. Br J Cancer 2015; 113:173-81. [PMID: 26079299 PMCID: PMC4647525 DOI: 10.1038/bjc.2015.182] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 04/14/2015] [Accepted: 04/22/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND South Asian migrants show lower cancer incidence than their host population in England for most major cancers. We seek to study the ethnic differences in survival from cancer. METHODS We described and modelled the effect of ethnicity, time, age and deprivation on survival for the five most incident cancers in each sex in South Asians in England between 1986 and 2004 using national cancer registry data. South Asian ethnicity was flagged using the validated name-recognition algorithm SANGRA (South Asian Names and Group Recognition Algorithm). RESULTS We observed survival advantage in South Asians in earlier periods. This ethnic gap either remained constant or narrowed over time. By 2004, age-standardised net survival was comparable for all cancers except three in men, where South Asians had higher survival 5 years after diagnosis: colorectal (58.9% vs 53.6%), liver (15.0% vs 9.4%) and lung (15.9% vs 9.3%). Compared with non-South Asians, South Asians experienced a slower increase in breast and prostate cancer survival, both cancers associated with either a screening programme or an early diagnosis test. We did not find differential patterns in survival by deprivation between both ethnicities. CONCLUSIONS Considering recent survival trends, appropriate action is required to avoid deficits in cancer survival among South Asians in the near future.
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Affiliation(s)
- C Maringe
- Faculty of Epidemiology and population Health, London school of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - R Li
- Faculty of Epidemiology and population Health, London school of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - P Mangtani
- Faculty of Epidemiology and population Health, London school of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - M P Coleman
- Faculty of Epidemiology and population Health, London school of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - B Rachet
- Faculty of Epidemiology and population Health, London school of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
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Parise C, Caggiano V. Disparities in the risk of the ER/PR/HER2 breast cancer subtypes among Asian Americans in California. Cancer Epidemiol 2014; 38:556-62. [DOI: 10.1016/j.canep.2014.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 07/17/2014] [Accepted: 08/03/2014] [Indexed: 01/15/2023]
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Wu TY, Lin C, Chen SL, Jung Y. A community-based intervention to promote breast cancer awareness and screening among Asian American women. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2014; 34:171-85. [PMID: 24928609 DOI: 10.2190/iq.34.2.e] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cancer is the leading cause of death for Asian Americans, and breast cancer is the leading cancer diagnosed among Asian American women. Despite the alarming facts, Asian American women have low breast cancer screening rates. This study examined the effects of a culturally appropriate community-based breast intervention program on participants' knowledge about breast cancer and intention for screening among Southeast Asian and South Asian women in Michigan. Data were collected from 166 women. At baseline, participants had limited knowledge of breast cancer screening guidelines and misconceptions about the risk factors of breast cancer. After the educational intervention, participants reported significantly higher knowledge scores related to breast cancer and screening recommendations and intentions to obtain follow-up CBE and mammograms. This culturally appropriate intervention provides strategies to overcome personal instructional barriers to meet the needs of this group for early detection and cancer control.
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Abstract
Breast cancer is the leading cause of cancer death for women worldwide. While breast cancer incidence is lower for many ethnic minority women than for white women, stage at diagnosis and survival are often worse. These disparities are most marked for African-American women, but are also present for Asians, Latinas, Native Americans and Hawaiians. The etiology of ethnic disparities in breast cancer is multifactorial, including differences in tumor characteristics, genetics, access to care and insurance, prevalence of risk factors, screening participation and processes of care, such as timeliness of diagnosis and quality of communication and treatment. This review will examine what is known regarding ethnic differences in all of these areas, what questions remain, and where researchers and policy makers should focus their future efforts.
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Affiliation(s)
- Leah S Karliner
- University of California, San Francisco, and Medical Effectiveness Research Center for Diverse Populations, San Francisco, CA, USA.
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Kwong SL, Stewart SL, Aoki CA, Chen MS. Disparities in hepatocellular carcinoma survival among Californians of Asian ancestry, 1988 to 2007. Cancer Epidemiol Biomarkers Prev 2010; 19:2747-57. [PMID: 20823106 PMCID: PMC3016919 DOI: 10.1158/1055-9965.epi-10-0477] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) represents a significant health disparity affecting Asian Americans, a population comprised of distinct ethnic groups. The purpose of this article is to analyze Californians of Asian ancestry with HCC with respect to socioeconomic status, demographic factors, stage of disease, treatment received, and survival. METHODS To investigate ethnic differences in survival, we analyzed ethnically disaggregated data from 6,068 Californians of Asian ancestry with HCC diagnosed in 1988 to 2007 and reported to the California Cancer Registry. RESULTS Compared with the average of all ethnic groups, cause-specific mortality was significantly higher among Laotian/Hmong [hazard ratio, 2.08; 95% confidence interval (95% CI), 1.78-2.44] and Cambodian patients (hazard ratio, 1.26; 95% CI, 1.06-1.51), groups with higher proportions of their populations at low levels of socioeconomic status; in addition, Laotian/Hmong patients disproportionately presented at later stages of disease, with only 3% receiving local surgical treatment, resection, or liver transplantation. After adjustment for time of diagnosis, age at diagnosis, gender, geographic region, stage at diagnosis, type of surgery, and socioeconomic status, survival disparities remained for both groups (Laotian/Hmong hazard ratio, 1.51; 95% CI, 1.28-1.79; Cambodian hazard ratio, 1.24; 95% CI, 1.03-1.48). CONCLUSIONS Our hypothesis that survival outcomes would differ by ethnicity was verified. IMPACT Research is needed not only to develop more effective treatments for HCC but also to develop community-based interventions to recruit Asian Americans, particularly Laotian/Hmong and Cambodians, for hepatitis B screening and into medical management to prevent or detect this tumor at an early stage.
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Affiliation(s)
- Sandy L Kwong
- Cancer Surveillance Research Unit, Cancer Surveillance and Research Branch, California Department of Public Health, San Francisco, CA, USA
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Boxwala FI, Bridgemohan A, Griffith DM, Soliman AS. Factors associated with breast cancer screening in Asian Indian women in metro-Detroit. J Immigr Minor Health 2010; 12:534-43. [PMID: 19629691 PMCID: PMC4276127 DOI: 10.1007/s10903-009-9277-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Few studies have examined social factors related to breast cancer screening in Asian Indian women in the Midwestern US. This cross-sectional, community-based survey utilized constructs of the Health Belief Model to examine factors associated with breast cancer screening among Asian Indian women in metropolitan Detroit, Michigan. Of the 160 participants, 63.8% reported receiving both a clinical breast exam and mammogram within the past 2 years. Women were more likely to screen for breast cancer if they had a college education, lived in the US for more years, perceived that breast cancer screening is useful in detecting breast cancer early, agreed that mammography was important, and received a recommendation by a healthcare provider to get a mammogram. These findings highlight the need for further research on regional differences in breast cancer screening knowledge, behaviors and predictors among Asian Pacific Islanders subgroups such as Asian Indian women who recently immigrated to the US.
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Affiliation(s)
- Fatema I Boxwala
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 109 Observatory St, Ann Arbor, MI 48109, USA
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Sadjadi A, Hislop TG, Bajdik C, Bashash M, Ghorbani A, Nouraie M, Babaei M, Malekzadeh R, Yavari P. Comparison of breast cancer survival in two populations: Ardabil, Iran and British Columbia, Canada. BMC Cancer 2009; 9:381. [PMID: 19863791 PMCID: PMC2773238 DOI: 10.1186/1471-2407-9-381] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Accepted: 10/28/2009] [Indexed: 11/10/2022] Open
Abstract
Background Patterns in survival can provide information about the burden and severity of cancer, help uncover gaps in systemic policy and program delivery, and support the planning of enhanced cancer control systems. The aim of this paper is to describe the one-year survival rates for breast cancer in two populations using population-based cancer registries: Ardabil, Iran, and British Columbia (BC), Canada. Methods All newly diagnosed cases of female breast cancer were identified in the Ardabil cancer registry from 2003 to 2005 and the BC cancer registry for 2003. The International Classification of Disease for Oncology (ICDO) was used for coding cancer morphology and topography. Survival time was determined from cancer diagnosis to death. Age-specific one-year survival rates, relative survival rates and weighted standard errors were calculated using life-tables for each country. Results Breast cancer patients in BC had greater one-year survival rates than patients in Ardabil overall and for each age group under 60. Conclusion These findings support the need for breast cancer screening programs (including regular clinical breast examinations and mammography), public education and awareness regarding early detection of breast cancer, and education of health care providers.
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Affiliation(s)
- Alireza Sadjadi
- 1Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences; Kargar Street, Tehran, Iran.
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Bates JH, Hofer BM, Parikh-Patel A. Cervical cancer incidence, mortality, and survival among Asian subgroups in California, 1990-2004. Cancer 2008; 113:2955-63. [PMID: 18980279 DOI: 10.1002/cncr.23752] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Aggregated cancer statistics for Asians mask important differences in cancer burden among Asian subgroups. The purpose of this study was to describe the relative patterns of cervical cancer incidence, mortality, and survival among Chinese, Filipino, Japanese, Korean, South Asian, and Vietnamese women in California, using data from the California Cancer Registry. METHODS All cervical cancer cases diagnosed among the 6 subgroups and non-Hispanic whites (NHW) from 1990 to 2004 were identified and used to calculate incidence and mortality rates and trends. The Kaplan-Meier method was used to calculate 5- and 10-year survival probabilities by subgroup, and Cox proportional hazards methodology was used to calculate survival differences adjusted for race and ethnicity, age, stage at diagnosis, socioeconomic status, and treatment factors. RESULTS Vietnamese and Korean women experienced greater cervical cancer incidence and mortality than NHW women, whereas rates among Chinese, Japanese, and South Asians were comparable or lower. Five-year unadjusted survival probabilities were greatest for South Asians (86%) and Koreans (86%), followed by Vietnamese (82%), Chinese (79%), and Filipinos (79%), as compared with NHW (78%) and Japanese (72%). The adjusted risk of cervical cancer death was significantly lower for South Asians, Koreans, Vietnamese, and Filipinos than for NHW women, but not for Chinese and Japanese. CONCLUSIONS Cervical cancer incidence rates vary substantially across the major Asian subgroups. Despite higher incidence and mortality rates compared with NHW women, Vietnamese, Koreans, and Filipinos have better survival outcomes. Further studies are needed to examine the factors behind these survival differences.
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Affiliation(s)
- Janet H Bates
- Public Health Institute, California Cancer Registry, Sacramento, California 95825, USA.
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Rastogi T, Devesa S, Mangtani P, Mathew A, Cooper N, Kao R, Sinha R. Cancer incidence rates among South Asians in four geographic regions: India, Singapore, UK and US. Int J Epidemiol 2007; 37:147-60. [PMID: 18094016 DOI: 10.1093/ije/dym219] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Data are limited regarding cancer incidence among Indians residing in different geographic regions around the world. Examining such rates may provide us with insights into future aetiological research possibilities as well as screening and prevention. METHODS Incidence rates for all cancers combined and 19 specific cancers were obtained for India from Globocan 2002, for Indians in Singapore from Cancer Incidence in Five Continents (VIII), and from national data sources for South Asians (SA) in the United Kingdom (UK) and for Asian Indians/Pakistanis (AIP) and whites in the United States (US). RESULTS We observed the lowest total cancer incidence rates in India (111 and 116 per 100,000 among males and females, respectively, age-standardized to the 1960 world population) and the highest among US whites (362 and 296). Cancer incidence rates among Indians residing outside of India were: intermediate Singapore (102 and 132), UK (173 and 179) and US ranges 152-176 and 142-164. A similar pattern was observed for cancers of the colorectum, prostate, thyroid, pancreas, lung, breast and non-Hodgkin lymphoma. In contrast, rates for cancers of the oral cavity, oesophagus, larynx and cervix uteri were highest in India. Although little geographic variability was apparent for stomach cancer incidence, Indians in Singapore had the highest rates compared with any other region. The UK SA and the US AIP appear with adopt the cancer patterns of their host country. CONCLUSION Variations in environmental exposures such as tobacco use, diet and infection, as well as better health care access and knowledge may explain some of the observed incidence differences.
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Affiliation(s)
- Tanuja Rastogi
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, NIH, DHHS, Rockville, MD 20852, USA
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Robbins AS, Koppie TM, Gomez SL, Parikh-Patel A, Mills PK. Differences in prognostic factors and survival among white and Asian men with prostate cancer, California, 1995-2004. Cancer 2007; 110:1255-63. [PMID: 17701951 DOI: 10.1002/cncr.22872] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND There are very limited data concerning survival from prostate cancer among Asian subgroups living in the U.S., a large proportion of whom reside in California. There do not appear to be any published data on prostate cancer survival for the more recently immigrated Asian subgroups (Korean, South Asian [SA], and Vietnamese). METHODS A study of prognostic factors and survival from prostate cancer was conducted in non-Hispanic whites and 6 Asian subgroups (Chinese, Filipino, Japanese, Korean, SA, and Vietnamese), using data from all men in California diagnosed with incident prostate cancer during 1995-2004 and followed through 2004 (n = 116,916). Survival was analyzed using Cox proportional hazards models. RESULTS Whites and Asians demonstrated significant racial differences in all prognostic factors: age, summary stage, primary treatment, histologic grade, socioeconomic status, and year of diagnosis. Every Asian subgroup had a risk factor profile that put them at a survival disadvantage compared with whites. Overall, the 10-year risk of death from prostate cancer was 11.9%. However, in unadjusted analyses Japanese men had significantly better survival than whites; Chinese, Filipino, Korean, and Vietnamese men had statistically equal survival; and SA men had significantly lower survival. On multivariate analyses adjusting for all prognostic factors, all subgroups except SA and Vietnamese men had significantly better survival than whites; the latter 2 groups had statistically equal survival. CONCLUSIONS Traditional prognostic factors for survival from prostate cancer do not explain why most Asian men have better survival compared with whites, but they do explain the poorer survival of SA men compared with whites.
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Affiliation(s)
- Anthony S Robbins
- California Cancer Registry, Public Health Institute, Sacramento, California, USA.
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Tammemagi CM. Racial/ethnic disparities in breast and gynecologic cancer treatment and outcomes. Curr Opin Obstet Gynecol 2007; 19:31-6. [PMID: 17218849 DOI: 10.1097/gco.0b013e3280117cf8] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To review recent research in racial/ethnic disparities in breast and gynecologic cancers, focusing on disparities occurring postdiagnosis. RECENT FINDINGS Mortality statistics show that of the cancers under study, breast cancer has the greatest impact, and of racial/ethnic groups, African Americans suffer the greatest disparities, with highest mortality rates for breast, uterine and cervical cancers, and second highest for ovarian cancer. Recent studies demonstrated that black breast cancer patients suffer more underuse of appropriate adjuvant therapy, and greater delays in diagnosis and institution of treatments, and blacks and Hispanics suffered greater postsurgical pain and symptomatology. Data indicate that the biology of some breast cancers in blacks is unique and more aggressive. One study demonstrated that more black breast cancer patients died of nonbreast cancer causes and that excessive comorbidity in blacks explained substantial amounts of survival disparity. Research is beginning to identify important disparities in nonblack minority racial/ethnic groups, including Hispanics and South Asian Americans. SUMMARY Research is continuing to identify and explain an important group of disparities - African American disparities in breast cancer outcomes. Disparities in other minority racial/ethnic groups, and in ovarian, uterine and cervical cancers, are at an emerging stage. Continuing efforts at all fronts are needed.
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Affiliation(s)
- C Martin Tammemagi
- Department of Community Health Sciences, Brock University, St Catharines, Ontario, Canada.
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