Asian Americans and prostate cancer: A nationwide population-based analysis
Asian Americans and prostate cancer: A nationwide population-based analysis
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DOI：
10.1016/j.urolonc.2015.11.013
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发表时间：
2016-05-01
影响因子：
2.7
通讯作者：
Quoc-Dien Trinh
中科院分区：
文献类型：
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作者：
Chao, Grace F.;Krishna, Nandita;Quoc-Dien Trinh
简介：目前尚不清楚亚裔美国人和太平洋岛民（PI）（AAPI）前列腺癌（PCa）的结局是否存在种族差异。我们研究了AAPI种族群体相对于非西班牙裔白色（NHW）群体在诊断、管理和生存方面的差异。（n = 891，100）在1988年至2010年期间在监测、流行病学和最终结果数据库中诊断为PCa的患者中提取并按种族分层：中国人，日本人，菲律宾人，夏威夷人，韩国人，越南人，亚洲印度人/巴基斯坦人，PI和其他亚洲人。评估了种族对就诊时分期、确定性治疗率和PCA特异性死亡率的影响。诊断时的严重程度定义为：局部（TxN 0 M0），区域（TxN 1 M0），或转移（TxNxM 1）。结果：相对于NHW，亚洲印度/巴基斯坦，菲律宾，夏威夷，PI男性有显着更差的结果。菲律宾（比值比[OR] = 1.38，95% CI：1.27-1.51），夏威夷人，（OR = 1.70，95% CI：1.41-2.04），亚裔印度人/巴基斯坦人PI男性（OR = 1.37，95% CI：1.15-1.64）和PI男性（OR = 1.90，95% CI：1.46-2.49）更易发生转移性PCa（P < 0.001）。在局限性PCa患者中，菲律宾男性接受明确治疗的可能性较小（OR = 0.91; 95% CI：0.84-0.97; P = 0.005）。除夏威夷人外，大多数AAPI组的PCa死亡率较低。（风险比= 1.52; 95%CI：1.30-1.77; P < 0.0001）和PI男性（风险比= 1.43; 95%CI：1.12-1.82; P < 0.0001）。与NHW相比，AAPI组更有可能出现晚期PCa，但癌症特异性生存率更高。相反，夏威夷和PI男性的PCA特异性死亡率风险更高。鉴于不同的癌症概况，我们的研究结果表明，有必要对AAPI数据进行分解。(C)2016 Elsevier Inc. All rights reserved.
Introduction: It remains largely unknown if there are racial disparities in outcomes of prostate cancer (PCa) for Asian American and Pacific Islanders (PIs) (AAPIs). We examined differences in diagnosis, management, and survival of AAPI ethnic groups, relative to their non-Hispanic White (NHW) counterparts.Methods: Patients (n = 891,100) with PCa diagnosed between 1988 and 2010 within the surveillance, epidemiology, and end results database were extracted and stratified by ethnic group: Chinese, Japanese, Filipino, Hawaiian, Korean, Vietnamese, Asian Indian/Pakistani, PI, and Other Asian. The effect of ethnic group on stage at presentation, rates of definitive treatment, and PCa-specific mortality was assessed. The severity at diagnosis was defined as: localized (TxN0M0), regional (TxN1M0), or metastatic (TxNxM1).Results: Relative to NHWs, Asian Indian/Pakistani, Filipino, Hawaiian, and PI men had significantly worse outcomes. Filipino (odds ratio [OR] = 1.38, 95% CI: 1.27-1.51), Hawaiian, (OR = 1.70, 95% CI: 1.41-2.04), Asian Indian/Pakistani (OR = 1.37, 95% CI: 1.15-1.64), and PI men (OR = 1.90, 95% CI: 1.46-2.49) were more likely to present with metastatic PCa (P < 0.001). In patients with localized PCa, Filipino men were less likely to receive definitive treatment (OR = 0.91; 95% CI: 0.84-0.97; P = 0.005). Most AAPI groups had lower rates of PCa death except for Hawaiian (hazard ratio = 1.52; 95% CI: 1.30-1.77; P < 0.0001) and PI men (hazard ratio = 1.43; 95% CI: 1.12-1.82; P < 0.0001).Conclusions: Compared with NHWs, AAPI groups were more likely to present with advanced PCa but had better cancer-specific survival. Conversely, Hawaiian and PI men were at greater risk for PCa-specific mortality. Given the different cancer profiles, our results show that there is a need for disaggregation of AAPI data. (C) 2016 Elsevier Inc. All rights reserved.