Disparities in clinical and demographic characteristics among Asian/Pacific Islander and Non-Hispanic White newly diagnosed lung cancer patients

• Published in: Cancer causes & control Vol. 33; no. 4; pp. 547 - 557
• Main Authors: Patel, Parth B., Alpert, Naomi, Taioli, Emanuela, Flores, Raja
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-04-2022; Springer Nature B.V
• Subjects: Adenocarcinoma; Asian Americans; Asians; Biomedical and Life Sciences; Biomedicine; Cancer Research; Demographics; Diagnosis; Epidemiology; Ethnicity; Female; Hematology; Histology; Humans; Lung cancer; Lung Neoplasms - diagnosis; Lung Neoplasms - epidemiology; Native Hawaiian or Other Pacific Islander; Oncology; Original Paper; Pacific Islander people; Patients; Public Health; Race factors; Regression analysis; Squamous cell carcinoma; Subgroups; Minority populations; Administrative database; Asian/Pacific Islanders; Racial disparities; Lung cancer
• ISSN: 0957-5243; 1573-7225
• DOI: 10.1007/s10552-021-01548-5

Purpose
Racial disparities persist among lung cancer patients but have not been adequately studied among Asian/Pacific Islander (API) subgroups, which are heterogeneous. This study compared clinical and demographic characteristics at diagnosis of API subgroups and NHW patients.
Methods
NHW and API adults diagnosed with lung cancer were identified from the Surveillance, Epidemiology, and End Results database (1990–2015). API was divided into eight subgroups: Chinese, Japanese, Filipino, Hawaiian/Pacific Islander, Korean, Vietnamese, Asian Indian/Pakistani, and Other. Multivariable multinomial logistic regression models were used to assess adjusted associations of clinical and demographic factors with API/subgroups.
Results
There were 522,702 (92.6%) NHW and 41,479 (7.4%) API lung cancer patients. API were less likely to be diagnosed at the age of ≥ 80 years (OR
adj
0.53, 95% CI 0.48–0.58 for ≥ 80 vs. ≤ 39 years) than NHW. However, Japanese patients were more often diagnosed at ≥ 80 years compared to other ethnic subgroups. API were less often female (OR
adj
0.85, 95% CI 0.83–0.86), and unmarried (OR
adj
0.71, 95% CI 0.68–0.74); however, among API, Japanese, Hawaiian/Pacific Islander, Korean, and Vietnamese were more often unmarried, compared to Chinese patients. API were more frequently diagnosed at stage IV, compared to stage I (OR
adj
1.31, 95% CI 1.27–1.35). API had significantly less squamous cell carcinoma (OR
adj
0.54, 95% CI 0.52–0.56, compared to adenocarcinoma); among API, Japanese, Filipino, Hawaiian/Pacific Islander, Korean, Asian Indian/Pakistani, and Other were more likely than Chinese patients to present with squamous cell histology (range: OR
adj
[Other] 1.24, 95% CI 1.09–1.41; OR
adj
[Hawaiian/Pacific Islander] 2.47, 95% CI 2.22–2.75).
Conclusion
At diagnosis, there are significant differences in demographic and clinical characteristics between NHW, API, and API subgroups. Treating API patients as a single population may overlook biological, environmental, and behavioral differences that might be beneficial in designing prevention strategies and treatment.