Survival of the Hmong population diagnosed with colon and rectal cancers in the United States

Author:

Walker Margaret R.1ORCID,Lor Kha2,Lor Kajua B.3,Vidri Roberto J.4,Hampton John M.5,Maldonado Cinthya6,Schiefelbein Andrea M.6,LoConte Noelle K.15

Affiliation:

1. Department of Medicine University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA

2. University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA

3. Medical College of Wisconsin School of Pharmacy Milwaukee Wisconsin USA

4. Division of Surgical Oncology, Department of Surgery University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA

5. University of Wisconsin Carbone Cancer Center Madison Wisconsin USA

6. Morgridge Institute for Research Madison Wisconsin USA

Abstract

AbstractBackgroundThe Hmong population constitutes an independent ethnic group historically dispersed throughout Southeast Asia; fallout from the Vietnam War led to their forced migration to the United States as refugees. This study seeks to investigate characteristics of the Hmong population diagnosed with in colorectal cancer (CRC) as well as survival within this population.MethodsCases of colon and rectal adenocarcinoma diagnosed between 2004 and 2017 were identified from the National Cancer Database (NCDB). Summary statistics of demographic, clinical, socioeconomic, and treatment variables were generated with emphasis on age and stage at the time of diagnosis. Cox‐proportional hazard models were constructed for survival analysis.ResultsOf 881,243 total CRC cases within the NCDB, 120 were classified as Hmong. The average age of Hmong individuals at diagnosis was 58.9 years compared 68.7 years for Non‐Hispanic White (NHW) individuals (p < 0.01). The distribution of analytic stage differed between the Hmong population and the reference NHW population, with 61.8% of Hmong individuals compared to 45.8% of NHW individuals with known stage being diagnosed at stage III or IV CRC compared to 0, I, or II (p = 0.001). However, there was no difference in OS when adjusting for potential confounders (HR 1.00 [0.77–1.33]; p = 0.998).ConclusionsHmong individuals are nearly a decade younger at the time of diagnosis of CRC compared to the NHW individuals. However, these data do not suggest an association between Hmong ethnicity and overall survival, when compared to the NHW population.

Funder

University of Wisconsin Carbone Cancer Center

Publisher

Wiley

Reference40 articles.

1. The Hmong Americans: Identity, conflict, and opportunity

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3. U.S. Census Bureau.SELECTED POPULATION PROFILE IN THE UNITED STATES 2017. American Community Survey ACS 1‐Year Estimates Selected Population Profiles Table S0201. https://data.census.gov/table/ACSSPP1Y2017.S0201?q=hmong population in 2017

4. Cancer patterns in Hmong in Minnesota, 2000 to 2012

5. Cancer incidence in the Hmong in California, 1988-2000

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