Disparities in cervical cancer survival among Asian-American women

• Published in: Annals of epidemiology Vol. 26; no. 1; pp. 28 - 35
• Main Authors: Nghiem, Van T., Davies, Kalatu R., Chan, Wenyaw, Mulla, Zuber D., Cantor, Scott B.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2016
• Subjects: Adenocarcinoma - ethnology; Adenocarcinoma - mortality; Adenoma - ethnology; Adenoma - mortality; Adult; Aged; Aged, 80 and over; Asian Americans; Carcinoma, Squamous Cell - ethnology; Carcinoma, Squamous Cell - mortality; Cervical cancer; Ethnicity; European Continental Ancestry Group; Female; Follow-Up Studies; Health care disparities; Health Status Disparities; Humans; Internal Medicine; Kaplan-Meier Estimate; Middle Aged; Proportional Hazards Models; Race; SEER Program; Survival; Survival Rate; United States; Uterine Cervical Neoplasms - ethnology; Uterine Cervical Neoplasms - mortality; United States; Ethnicity; Health care disparities; Asian-Americans; Survival; Cervical cancer; Race
• ISSN: 1047-2797; 1873-2585
• DOI: 10.1016/j.annepidem.2015.10.004

We compared overall survival and influencing factors between Asian-American women as a whole and by subgroup with white women with cervical cancer. Cervical cancer data were from the Surveillance, Epidemiology, and End Results registry; socioeconomic information was from the Area Health Resource File. We used standard tests to compare characteristics between groups; the Kaplan-Meier method with log-rank test to assess overall survival and compare it between groups; and Cox proportional hazards models to determine the effect of race and other covariates on overall survival (with and/or without age stratification). Being 3.3 years older than white women at diagnosis (P < .001), Asian-American women were more likely to be in a spousal relationship, had more progressive disease, and were better off socioeconomically. Women of Filipino, Japanese, and Korean origin had similar clinical characteristics compared to white women. Asian-American women had higher 36- and 60-month survival rates (P = .004 and P = .013, respectively), higher overall survival rates (P = .049), and longer overall survival durations after adjusting for age and other covariates (hazard ratio = 0.77, 95% confidence interval: 0.68–0.86). Overall survival differed across age strata between the two racial groups. With the exception of women of Japanese or Korean origin, Asian-American women grouped by geographic origin had better overall survival than white women. Although Asian-American women, except those of Japanese or Korean origin, had better overall survival than white women, their older age at cervical cancer diagnosis suggests that they have less access to screening programs.