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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
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 differ...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10075171/ https://www.ncbi.nlm.nih.gov/pubmed/37017832 http://dx.doi.org/10.1245/s10434-023-13339-0 |
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author | 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. Dee, Edward Christopher |
author_facet | 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. Dee, Edward Christopher |
author_sort | Jain, Bhav |
collection | PubMed |
description | 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1245/s10434-023-13339-0. |
format | Online Article Text |
id | pubmed-10075171 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-100751712023-04-06 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 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. Dee, Edward Christopher Ann Surg Oncol Colorectal Cancer 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1245/s10434-023-13339-0. Springer International Publishing 2023-04-05 /pmc/articles/PMC10075171/ /pubmed/37017832 http://dx.doi.org/10.1245/s10434-023-13339-0 Text en © Society of Surgical Oncology 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Colorectal Cancer 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. Dee, Edward Christopher 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Colorectal Cancer |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10075171/ https://www.ncbi.nlm.nih.gov/pubmed/37017832 http://dx.doi.org/10.1245/s10434-023-13339-0 |
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