Abstract
Abstract
Background
The United States Census Bureau recommends distinguishing between “Asians” vs. “Native Hawaiians or Other Pacific Islanders” (NHOPI). We tested for prognostic differences according to this stratification in patients with prostate cancer (PCa) of all stages.
Methods
Descriptive statistics, time-trend analyses, Kaplan–Meier plots and multivariate Cox regression models were used to test for differences at diagnosis, as well as for cancer specific mortality (CSM) according to the Census Bureau’s definition in either non-metastatic or metastatic patients vs. 1:4 propensity score (PS)-matched Caucasian controls, identified within the Surveillance, Epidemiology and End Results database (2004–2016).
Results
Of all 380,705 PCa patients, NHOPI accounted for 1877 (0.5%) vs. 23,343 (6.1%) remaining Asians vs. 93.4% Caucasians. NHOPI invariably harbored worse PCa characteristics at diagnosis. The rates of PSA ≥ 20 ng/ml, Gleason ≥ 8, T3/T4, N1- and M1 stages were highest for NHOPI, followed by Asians, followed by Caucasians (PSA ≥ 20: 18.4 vs. 14.8 vs. 10.2%, Gleason ≥ 8: 24.9 vs. 22.1, vs. 15.9%, T3/T4: 5.5 vs. 4.2 vs. 3.5%, N1: 4.4 vs. 2.8, vs. 2.7%, M1: 8.3 vs. 4.9 vs. 3.9%). Despite the worst PCa characteristics at diagnosis, NHOPI did not exhibit worse CSM than Caucasians. Moreover, despite worse PCa characteristics, Asians exhibited more favorable CSM than Caucasians in comparisons that focussed on non-metastatic and on metastatic patients.
Conclusions
Our observations corroborate the validity of the distinction between NHOPI and Asian patients according to the Census Bureau’s recommendation, since these two groups show differences in PSA, grade and stage characteristics at diagnosis in addition to exhibiting differences in CSM even after PS matching and multivariate adjustment.
Publisher
Springer Science and Business Media LLC
Reference20 articles.
1. Brawley OW (2016) Some thoughts on health surveillance data, race, and population categorization. CA Cancer J Clin 66(3):179–181
2. Budget OoMa (1997) Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity; Federal Register Notice, October 30, 1997. official website of The White House, President Barack Obama. https://obamawhitehouse.archives.gov/omb/fedreg_1997standards; Accessed 12 Sept 2019
3. US-Census-Bureau (2019) Asian–American and Pacific Islander Heritage Month: May 2019. official website of United States Census Bureau. https://www.census.gov/newsroom/facts-for-features/2019/asian-american-pacific-islander.html. Accessed 12 Sept 2019
4. US-Census-Bureau (2011) Asian alone or in combination with one or more other races, and with one or more asian categories for selected groups. official website of United States Census Bureau. https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=bkmk. Accessed Sept 12 2019
5. Colby SL, Ortman JM (2015) Projections of the size and composition of the U.S. population: 2014 to 2060. official website of United States Census Bureau. https://census.gov/content/dam/Census/library/publications/2015/demo/p25-1143.pdf. Accessed Sept 12 2019
Cited by
11 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献