1
|
Li D, Cheng S, Wilson Woods A, Luong A, Schiltz S, Tan R, Chi ZH. Why Liver Cancer Hits Home: Bridging Healthcare Disparities in the Asian American and Pacific Islander Community. J Hepatocell Carcinoma 2024; 11:1439-1444. [PMID: 39050811 PMCID: PMC11268783 DOI: 10.2147/jhc.s467913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/03/2024] [Indexed: 07/27/2024] Open
Abstract
Asian Americans and Pacific Islanders have an increased risk of developing liver cancer and higher risk of death compared to non-Hispanic White individuals. The role of individual-level risk factors, social determinants of health, and barriers navigating health systems present unique challenges in obtaining liver cancer care for these patients. Additionally, the Asian American and Pacific Islander population is a heterogenous group originating from several different countries and speaking various languages, and they are often underrepresented in cancer clinical trial populations. This article describes the challenges faced by Asian American and Pacific Islander patients with liver cancer from the clinician, research, and patient advocacy perspectives and proposes targeted solutions to reduce healthcare disparities in this group.
Collapse
Affiliation(s)
- Daneng Li
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | | | - Andrea Wilson Woods
- Blue Faery: The Adrienne Wilson Liver Cancer Association, Birmingham, AL, USA
| | - Allyson Luong
- Blue Faery: The Adrienne Wilson Liver Cancer Association, Birmingham, AL, USA
| | - Sarah Schiltz
- Blue Faery: The Adrienne Wilson Liver Cancer Association, Birmingham, AL, USA
| | | | | |
Collapse
|
2
|
Albazee E, Alharran AM, Alzayed MM, Alharran YM, Alyaqout FB, Almutairi A, Abu-Zaid A. Insights From the National Inpatient Sample (2016-2019) on Laryngeal Cancer Incidence and Trends. Cureus 2024; 16:e61660. [PMID: 38835555 PMCID: PMC11149681 DOI: 10.7759/cureus.61660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Laryngeal cancer has a significant impact on speech, swallowing, and quality of life. This study aims to analyze laryngeal cancer trends using the National Inpatient Sample (NIS) database, providing insights into its epidemiology. METHODS Data from the NIS database was analyzed for a cohort of 14,282 laryngeal cancer cases from 2016 to 2019. Baseline characteristics and demographic parameters, including primary expected payer, age groups, hospital types, and geographic regions, were examined. Descriptive statistics and trend analysis were conducted. RESULTS The cohort showed consistent annual case numbers (range: 3739-3948). The highest case numbers were in the 40-64 age group (average 1998 cases/year), followed by the 65-80 age group (average 1473 cases/year). Medicare was the most common primary expected payer, followed by Medicaid, private insurance, self-pay, and no charge. The cohort was roughly three times more skewed toward males, with an average of 2936 male cases per year compared to 885 female cases. Notable trends included significant positive correlations with time for urban teaching hospitals, the South region, older age group (65-80 years), and Asian or Pacific Islander individuals. However, the overall correlation between case numbers and time was not statistically significant. The primary expected payer and deaths exhibited moderate correlations with time but did not reach statistical significance. CONCLUSION This study provides insights into the baseline characteristics and trends in laryngeal cancer incidence. The observed demographic shifts highlight the need for further investigation into underlying factors influencing case distribution. Understanding these trends can guide targeted interventions for prevention, early detection, and treatment of laryngeal cancer.
Collapse
Affiliation(s)
- Ebraheem Albazee
- Department of Internship, Kuwait Institute for Medical Specializations, Kuwait City, KWT
| | | | | | | | | | | | | |
Collapse
|
3
|
Ðoàn LN, Chau MM, Ahmed N, Cao J, Chan SWC, Yi SS. Turning the Health Equity Lens to Diversity in Asian American Health Profiles. Annu Rev Public Health 2024; 45:169-193. [PMID: 38134402 DOI: 10.1146/annurev-publhealth-060222-023852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
The monolithic misrepresentation of Asian American (AsAm) populations has maintained assumptions that AsAm people are not burdened by health disparities and social and economic inequities. However, the story is more nuanced. We critically review AsAm health research to present knowledge of AsAm health profiles from the past two decades and present findings and opportunities across three topical domains: (a) general descriptive knowledge, (b) factors affecting health care uptake, and (c) effective interventions. Much of the literature emphasized underutilization of health care services; low knowledge and awareness among AsAms about health-related risk factors, prevention, diagnosis, and treatment; inadequate efforts by health systems to improve language access, provider-patient communication, and trust; and the critical roles of community- and faith-based organizations and leaders in health promotion initiatives. Future opportunities for AsAm health research will require adoption of and significant investment in community-engaged research infrastructure to increase representation, funding, and research innovation for AsAm communities.
Collapse
Affiliation(s)
- Lan N Ðoàn
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| | - Michelle M Chau
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| | - Naheed Ahmed
- Institute for Excellence in Health Equity, NYU Grossman School of Medicine, New York University, New York, NY, USA
| | - Jiepin Cao
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| | - Sze Wan Celine Chan
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| | - Stella S Yi
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York University, New York, NY, USA;
| |
Collapse
|
4
|
Islam JY, Hathaway CA, Hume E, Turner K, Hallanger-Johnson J, Tworoger SS, Camacho-Rivera M. Racial and Ethnic Inequities in Cancer Care Continuity During the COVID-19 Pandemic Among Those With SARS-CoV-2. JAMA Netw Open 2024; 7:e2412050. [PMID: 38767916 PMCID: PMC11107297 DOI: 10.1001/jamanetworkopen.2024.12050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/15/2024] [Indexed: 05/22/2024] Open
Abstract
Importance Racially and ethnically minoritized US adults were disproportionately impacted by the COVID-19 pandemic and experience poorer cancer outcomes, including inequities in cancer treatment delivery. Objective To evaluate racial and ethnic disparities in cancer treatment delays and discontinuations (TDDs) among patients with cancer and SARS-CoV-2 during different waves of the COVID-19 pandemic in the United States. Design, Setting, and Participants This cross-sectional study used data from the American Society of Clinical Oncology Survey on COVID-19 in Oncology Registry (data collected from April 2020 to September 2022), including patients with cancer also diagnosed with SARS-CoV-2 during their care at 69 US practices. Racial and ethnic differences were examined during 5 different waves of the COVID-19 pandemic in the United States based on case surge (before July 2020, July to November 2020, December 2020 to March 2021, April 2021 to February 2022, and March to September 2022). Exposures Race and ethnicity. Main Outcomes and Measures TDD was defined as any cancer treatment postponed more than 2 weeks or cancelled with no plans to reschedule. To evaluate TDD associations with race and ethnicity, adjusted prevalence ratios (aPRs) were estimated using multivariable Poisson regression, accounting for nonindependence of patients within clinics, adjusting for age, sex, body mass index, comorbidities, cancer type, cancer extent, and SARS-CoV-2 severity (severe defined as death, hospitalization, intensive care unit admission, or mechanical ventilation). Results A total of 4054 patients with cancer and SARS-CoV-2 were included (143 [3.5%] American Indian or Alaska Native, 176 [4.3%] Asian, 517 [12.8%] Black or African American, 469 [11.6%] Hispanic or Latinx, and 2747 [67.8%] White; 2403 [59.3%] female; 1419 [35.1%] aged 50-64 years; 1928 [47.7%] aged ≥65 years). The analysis focused on patients scheduled (at SARS-CoV-2 diagnosis) to receive drug-based therapy (3682 [90.8%]), radiation therapy (382 [9.4%]), surgery (218 [5.4%]), or transplant (30 [0.7%]), of whom 1853 (45.7%) experienced TDD. Throughout the pandemic, differences in racial and ethnic inequities based on case surge with overall TDD decreased over time. In multivariable analyses, non-Hispanic Black (third wave: aPR, 1.56; 95% CI, 1.31-1.85) and Hispanic or Latinx (third wave: aPR, 1.35; 95% CI, 1.13-1.62) patients with cancer were more likely to experience TDD compared with non-Hispanic White patients during the first year of the pandemic. By 2022, non-Hispanic Asian patients (aPR, 1.51; 95% CI, 1.08-2.12) were more likely to experience TDD compared with non-Hispanic White patients, and non-Hispanic American Indian or Alaska Native patients were less likely (aPR, 0.37; 95% CI, 0.16-0.89). Conclusions and Relevance In this cross-sectional study of patients with cancer and SARS-CoV-2, racial and ethnic inequities existed in TDD throughout the pandemic; however, the disproportionate burden among racially and ethnically minoritized patients with cancer varied across SARS-CoV-2 waves. These inequities may lead to downstream adverse impacts on cancer mortality among minoritized adults in the United States.
Collapse
Affiliation(s)
- Jessica Y. Islam
- Center for Immunization and Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Cassandra A. Hathaway
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Emma Hume
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Kea Turner
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | | | - Shelley S. Tworoger
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
- Division of Oncological Sciences, School of Medicine, Oregon Health & Science University, Portland
| | - Marlene Camacho-Rivera
- Department of Community Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, New York, New York
| |
Collapse
|
5
|
Thompson CA, Nianogo RA, Leonard T. Unaffordable housing and cancer: novel insights into a complex question. JNCI Cancer Spectr 2024; 8:pkae029. [PMID: 38708930 PMCID: PMC11071115 DOI: 10.1093/jncics/pkae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 03/24/2024] [Indexed: 05/07/2024] Open
Affiliation(s)
- Caroline A Thompson
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Center for Health Promotion and Disease Prevention, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Roch A Nianogo
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Tammy Leonard
- Department of Health Economics and Policy, O’Donnell School of Public Health and Harold C. Simmons Comprehensive Cancer Center, UT Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
6
|
Seelam B, Sandhu R, Alam M, Kethireddy A, Zapata I. Rates of Compliance in South Indian American Communities of Southern California Regarding Cancer Screening. Clin Pract 2024; 14:337-343. [PMID: 38391412 PMCID: PMC10888186 DOI: 10.3390/clinpract14010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Studies have shown lower rates of cancer screening and high mortality rates among all Asian Americans than among non-Hispanic White populations. However, most of these studies often confound diverse Asian American subgroups with limited data on cancer screening for Indian Americans, with this group being particularly interesting because of their counterintuitive socioeconomic status. For this reason, the objective of this study is to evaluate knowledge of the United States Preventive Services Task Force (USPSTF) cancer screening guidelines and compliance among South Indian Americans residing in Southern California. METHODS This was a cross-sectional study gathering community responses through an electronic survey. The survey reports knowledge of USPSTF screening guidelines and participant compliance rates. Rates were further compared to non-Hispanic White populations from official sources. RESULTS South Indian Americans residing in California had lower rates of compliance for colorectal, lung, and breast cancer screening when compared to that of non-Hispanic White populations in the same region, with the exception of cervical cancer screening rates. CONCLUSION Understanding the cultural characteristics of special populations, such as Indian Americans, can help communities adhere to more effective screening practices that can improve outcomes.
Collapse
Affiliation(s)
- Bhavana Seelam
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT 84738, USA
| | - Ria Sandhu
- Rocky Vista University College of Osteopathic Medicine, Ivins, UT 84738, USA
| | - Mariam Alam
- Rocky Vista University College of Osteopathic Medicine, Englewood, CO 80112, USA
| | | | - Isain Zapata
- Department of Biomedical Sciences, Rocky Vista University College of Osteopathic Medicine, Englewood, CO 80112, USA
| |
Collapse
|
7
|
Kooragayala K, Lou J, Dibato J, Hong YK. Disparities in Pancreatic Cancer Outcomes in the Disaggregated Asian American Population. Ann Surg Oncol 2024; 31:1298-1309. [PMID: 37880517 DOI: 10.1245/s10434-023-14454-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/04/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND The Asian American, Native Hawaiian, and Pacific Islander (AANHPI) population is among the fastest-growing population in the USA. However, this is not reflected in scientific research, in which ethnic groups are often combined. We identified trends in treatment and outcomes for pancreatic cancer in a disaggregated AANHPI population. We hypothesize that patients from different AANHPI groups have differences in survival. PATIENTS AND METHODS A retrospective analysis of the National Cancer Database between 2010 and 2019 identified patients treated for pancreatic cancer. We identified demographic factors for patients of Caucasian, African American, and disaggregated Asian subpopulations. Survival curves were generated and multivariate analysis was performed to help determine which factors impacted overall survival. RESULTS A total of 296,448 patients met the inclusion criteria. Of those, 8568 (3%) patients were Asian. Median survival of AANHPI patients was 11.3 months, as compared with Caucasians (8.9 months) and African Americans (8.1 months) (p < 0.0001). Asian Indians had the highest median survival (14.3 months), whereas the Japanese subpopulation had the lowest (7.6 months) (p < 0.0001). There were significant differences in median survival between the different AANHPI subpopulations irrespective of stage. Multivariate analysis demonstrated that belonging to an AANHPI racial/ethnic group, excluding Japanese and Filipino, was associated with decreased risk of overall mortality. DISCUSSION Significant differences were identified in the overall median survival for patients with pancreatic cancer between AANHPI subpopulations. Disparities in socioeconomic factors may have played a role in overall survival. This study highlights the need to include disaggregated data in future studies to subdue disparities in cancer care for patients.
Collapse
Affiliation(s)
| | - Johanna Lou
- Department of Surgery, Cooper University Hospital, Camden, NJ, USA
| | - John Dibato
- Department of Surgery, Cooper University Hospital, Camden, NJ, USA
| | - Young Ki Hong
- Department of Surgery, Cooper University Hospital, Camden, NJ, USA.
| |
Collapse
|
8
|
Lim DW, Li WW, Giannakeas V, Cil TD, Narod SA. Survival of Filipino women with breast cancer in the United States. Cancer Med 2023; 12:19921-19934. [PMID: 37755311 PMCID: PMC10587940 DOI: 10.1002/cam4.6403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 07/18/2023] [Accepted: 07/23/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND The survival of women with early-stage breast cancer varies by racial group. Filipino women with breast cancer are an understudied group and are often combined with other Asian groups. We compared clinical presentations and survival rates for Filipino and White women with breast cancer diagnosed in the United States. METHODS We conducted a retrospective cohort study of women with breast cancer diagnosed between 2004 and 2015 in the SEER18 registries database. We compared crude survival between Filipino and White women. We then calculated adjusted hazard ratios (HR) in a propensity-matched design using the Cox proportional hazards model. RESULTS There were 10,834 Filipino (2.5%) and 414,618 White women (97.5%) with Stage I-IV breast cancer in the SEER database. The mean age at diagnosis was 57.5 years for Filipino women and 60.8 years for White women (p < 0.0001). Filipino women had more high-grade and larger tumors than White women and were more likely to have node-positive disease. Among women with Stage I-IIIC breast cancer, the crude 10-year breast cancer-specific survival rate was 91.0% for Filipino and 88.9% for White women (HR 0.81, 95% CI 0.74-0.88, p < 0.01). In a propensity-matched analysis, the HR was 0.73 (95% CI 0.66-0.81). The survival advantage for Filipino women was present in subgroups defined by age of diagnosis, nodal status, estrogen receptor status, and HER2 receptor status. CONCLUSION In the United States, Filipino women often present with more advanced breast cancers than White women, but experience better breast cancer-specific survival.
Collapse
Affiliation(s)
- David W. Lim
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Women's College Research Institute, Women's College HospitalTorontoOntarioCanada
- Department of SurgeryWomen's College HospitalTorontoOntarioCanada
- Division of General Surgery, Department of SurgeryUniversity of TorontoTorontoOntarioCanada
| | - Winston W. Li
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
| | - Vasily Giannakeas
- Women's College Research Institute, Women's College HospitalTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Tulin D. Cil
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Department of SurgeryWomen's College HospitalTorontoOntarioCanada
- Division of General Surgery, Department of SurgeryUniversity of TorontoTorontoOntarioCanada
- Division of General SurgeryUniversity Health Network (Princess Margaret Cancer Centre)TorontoOntarioCanada
| | - Steven A. Narod
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Women's College Research Institute, Women's College HospitalTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Institute of Medical Science, University of TorontoTorontoOntarioCanada
| |
Collapse
|
9
|
Gao JJ, Pazdur R, Kim T. Advancing Therapies for Asian Americans, Native Hawaiians, and Other Pacific Islanders With Cancer: OCE's Project ASIATICA. JCO Oncol Pract 2023; 19:704-705. [PMID: 37384849 DOI: 10.1200/op.23.00198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/04/2023] [Accepted: 05/22/2023] [Indexed: 07/01/2023] Open
Abstract
Project ASIATICA is a new @FDAOncology initiative focusing on AA & NHPI patients with cancer. @drjennifergao @tamykim27 @realrickpazdur
Collapse
Affiliation(s)
- Jennifer J Gao
- US Food and Drug Administration, Oncology Center of Excellence, Silver Spring, MD
| | - Richard Pazdur
- US Food and Drug Administration, Oncology Center of Excellence, Silver Spring, MD
| | - Tamy Kim
- US Food and Drug Administration, Oncology Center of Excellence, Silver Spring, MD
| |
Collapse
|
10
|
Sakoda LC, Alabaster A, Sumner ET, Gordon NP, Quesenberry CP, Velotta JB. Trends in Smoking-Specific Lung Cancer Incidence Rates Within a US Integrated Health System, 2007-2018. Chest 2023; 164:785-795. [PMID: 36934804 DOI: 10.1016/j.chest.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND At least 10% of lung cancers arise in adults who have never used tobacco. Data remain inconclusive on whether lung cancer incidence has been increasing among adults who have never used tobacco. RESEARCH QUESTION How have age-adjusted incidence rates of lung cancer changed temporally, especially among adults who have never used tobacco? STUDY DESIGN AND METHODS Trends in lung cancer incidence were examined using linked electronic health record and cancer registry data on a dynamic cohort of adults ≥ 30 years of age at risk of incident lung cancer between January 1, 2007, and December 31, 2018, from an integrated health-care system in northern California. Truncated age-adjusted lung cancer incidence rates and average annual percentage change (AAPC) in rates were estimated, overall and separately for adults who have ever and never used tobacco by age, sex, and race or ethnicity. RESULTS The cohort included 3,751,348 adults (52.5% female, 48.0% non-Hispanic White, 63.1% have never used tobacco), among whom 18,627 (52.7% female, 68.6% non-Hispanic White, 15.4% have never used tobacco) received a diagnosis of lung cancer. The overall lung cancer incidence rate declined from 91.1 to 63.7 per 100,000 person-years between 2007 and 2009 and between 2016 and 2018 (AAPC, -3.9%; 95% CI, -4.2% to -3.6%). Among adults who have ever used tobacco, incidence rates declined overall from 167.0 to 113.4 per 100,000 person-years (AAPC, -4.2%; 95% CI, -4.4% to -3.9%) and, to varying degrees, within all age, sex, and racial or ethnic groups. Among adults who have never used tobacco, incidence rates were relatively constant, with 3-year-period estimates ranging from 19.9 to 22.6 per 100,000 person-years (AAPC, 0.9%; 95% CI, -0.3% to 2.1%). Incidence rates for adults who have never used tobacco seemed stable over time, within age, sex, and racial or ethnic groups, except for those of Asian and Pacific Islander (API) origin (AAPC, 2.0%; 95% CI, 0.1%-3.9%), whose rates were about twice as high compared with their counterparts. INTERPRETATION These observed trends underscore the need to elucidate further the cause of lung cancer in adults who have never used tobacco, including why incidence is higher and rising in API adults who have never used tobacco.
Collapse
Affiliation(s)
- Lori C Sakoda
- Division of Research, Kaiser Permanente Northern California, Oakland, CA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA.
| | - Amy Alabaster
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Eric T Sumner
- Department of Pulmonary and Critical Care Medicine, Kaiser Permanente Northern California, Oakland, CA
| | - Nancy P Gordon
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | | | - Jeffrey B Velotta
- Department of Thoracic Surgery, Kaiser Permanente Northern California, Oakland, CA
| |
Collapse
|
11
|
Shusted CS, Barta JA, Nguyen A, Wen KY, Juon HS, Zeigler-Johnson C. Characterizing Lung Cancer Burden Among Asian-American Communities in Philadelphia. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01723-1. [PMID: 37540304 DOI: 10.1007/s40615-023-01723-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 06/08/2023] [Accepted: 07/06/2023] [Indexed: 08/05/2023]
Abstract
Lung cancer (LC) is the leading cause of cancer death among Asian-Americans. However, there are differences in LC incidence and mortality among Asian racial subgroups. The objective of this study was to describe LC burden and disparities among race/ethnic groups (White, Black, Asian, and Hispanic) across US census tracts (CT) in Philadelphia using the Pennsylvania Cancer Registry dataset (N=11,865). ArcGIS Pro was used to geocode patient addresses to the CT level for linkage to US Census data. Despite being diagnosed more frequently with advanced-stage lung cancer compared with other race and ethnic groups in Philadelphia, Asian patients were most likely to be alive at the time of data receipt. Among Asian subgroups, Korean patients were the oldest (median age 75, p=0.024). Although not statistically different, distant stage disease was the most prevalent among Asian Indian (77.8%) and Korean (73.7%) and the least prevalent among Chinese patients (49.5%). LC was the cause of death for 77.8% of Asian Indian, 63.2% of Korean, 52.9% of other Asian, 48.5% of Chinese, and 47.5% of Vietnamese patients. CTs where Asian individuals were concentrated had lower socioeconomic status and greater tobacco retailer density compared to the entire city. Compared to all of Philadelphia, heavily Asian CTs experienced a greater age-standardized LC incidence (1.48 vs. 1.42) but lower age-standardized LC mortality (1.13 vs. 1.22). Our study suggests that LC disparities exist among Asian subgroups, with Asian Indian and Korean Philadelphians most likely to present with advanced disease. Additional studies are needed to investigate LC among high-risk racial and ethnic groups, including Asian subgroups.
Collapse
Affiliation(s)
- Christine S Shusted
- Division of Pulmonary and Critical Care Medicine, The Jane and Leonard Korman Respiratory Institute at Thomas Jefferson University, Philadelphia, PA, USA
| | - Julie A Barta
- Division of Pulmonary and Critical Care Medicine, The Jane and Leonard Korman Respiratory Institute at Thomas Jefferson University, Philadelphia, PA, USA
| | - Anh Nguyen
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Kuang-Yi Wen
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Hee-Soon Juon
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Charnita Zeigler-Johnson
- Fox Chase Cancer Center, Cancer Prevention and Control, 4141 Young Pavilion, 333 Cottman Avenue, Philadelphia, PA, USA.
| |
Collapse
|
12
|
Patel SR, Suero-Abreu GA, Ai A, Ramachandran MK, Meza K, Florez N. Inequity in care delivery in cardio-oncology: dissecting disparities in underrepresented populations. Front Oncol 2023; 13:1124447. [PMID: 37361603 PMCID: PMC10289233 DOI: 10.3389/fonc.2023.1124447] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/03/2023] [Indexed: 06/28/2023] Open
Abstract
It is well known that patients with cancer have a significantly higher cardiovascular mortality risk than the general population. Cardio-oncology has emerged to focus on these issues including risk reduction, detection, monitoring, and treatment of cardiovascular disease or complications in patients with cancer. The rapid advances in early detection and drug development in oncology, along with socioeconomic differences, racial inequities, lack of support, and barriers to accessing quality medical care, have created disparities in various marginalized populations. In this review, we will discuss the factors contributing to disparities in cardio-oncologic care in distinct populations, including Hispanic/Latinx, Black, Asian and Pacific Islander, indigenous populations, sex and gender minorities, and immigrants. Some factors that contribute to differences in outcomes in cardio-oncology include the prevalence of cancer screening rates, genetic cardiac/oncologic risk factors, cultural stressors, tobacco exposure rates, and physical inactivity. We will also discuss the barriers to cardio-oncologic care in these communities from the racial and socioeconomic context. Appropriate and timely cardiovascular and cancer care in minority groups is a critical component in addressing these disparities, and there need to be urgent efforts to address this widening gap.
Collapse
Affiliation(s)
- Shruti Rajesh Patel
- Department of Medicine, Division of Oncology, Stanford University and Stanford Cancer Institute, Stanford, CA, United States
| | | | - Angela Ai
- Olive View-University of California, Los Angeles Medical Center, Los Angeles, CA, United States
| | - Maya K. Ramachandran
- Department of Medicine, Division of Oncology, Stanford University and Stanford Cancer Institute, Stanford, CA, United States
| | - Kelly Meza
- Dana Farber Cancer Institute, Boston, MA, United States
| | | |
Collapse
|
13
|
Kohli K, Jain B, Dee EC. Crossing Borders: Improving Mental Health Outcomes in Asian American Immigrants With Cancer. JCO Oncol Pract 2023; 19:234-237. [PMID: 36821806 DOI: 10.1200/op.22.00740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Affiliation(s)
| | - Bhav Jain
- Massachusetts Institute of Technology, Cambridge, MA
| | | |
Collapse
|
14
|
Xi D, Lei M, Liu P, Vemuri R, Ye Y. Advancing equity through strengthening research on health and well-being of Asian American, Native Hawaiian, and Pacific Islander. Cell Biosci 2022; 12:101. [PMID: 35790999 PMCID: PMC9254580 DOI: 10.1186/s13578-022-00834-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/15/2022] [Indexed: 11/18/2022] Open
Abstract
The National Institutes of Health’s Asian American, Native Hawaiian and Pacific Islander Health Scientific Interest Group (NIH AANHPI-HSIG) provides a viewpoint on developing approaches to enhance research on health and wellbeing for Asian American, Native Hawaiian, and Pacific Islander ethnic populations, in order to advance racial equity amongst such populations.
Collapse
|