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Erschienen in: Annals of Surgical Oncology 9/2009

01.09.2009 | Healthcare Policy and Outcomes

Disparities in Gastric Cancer Outcomes Among Asian Ethnicities in the USA

verfasst von: Joseph Kim, MD, Brian Mailey, MD, Maheswari Senthil, MD, Avo Artinyan, MD, MS, Can-Lan Sun, MD, PhD, Smita Bhatia, MD, MPH

Erschienen in: Annals of Surgical Oncology | Ausgabe 9/2009

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Abstract

Background

Survival for gastric cancer is reportedly higher in Asians than for other races. It is unclear whether differences in outcome exist among Asian ethnicities. Our objective was to assess gastric cancer survival in Asian ethnic groups in a large heterogeneous population.

Methods

Asian-Americans treated for gastric adenocarcinoma between 1988 and 2006 were identified from the Los Angeles County Cancer Surveillance Program. Patients were stratified and compared by ethnicity (Korean, Japanese, Chinese, Vietnamese or Filipino).

Results

Of the 1,817 Asian-Americans in the study cohort, 45% (n = 810) were Korean, 25% (n = 462) were Chinese, 11% (n = 193) were Japanese, 10% (n = 188) were Filipino, and 9% (n = 164) were Vietnamese. For the entire cohort Koreans and Filipinos had the longest and shortest median survival (MS), respectively (22.4 and 10.3 months, respectively; P < 0.001). Multivariate analysis demonstrated that Japanese and Filipino ethnicity independently predicted worse survival compared with Korean ethnicity [hazard ratio (HR) 1.37, 95% confidence interval (CI) 1.08–1.73, P = 0.008; and HR 1.71, 95% CI 1.37–2.13, P < 0.001, respectively]. In the surgical cohort, Koreans and Filipinos had the longest and shortest survival, respectively (MS of 57.8 and 21.7 months, respectively; P < 0.001). Multivariate analysis of the surgical cohort also demonstrated that Japanese and Filipino ethnicity independently predicted worse survival compared with Korean ethnicity (HR 1.61, 95% CI 1.22–2.13, P < 0.001; and HR 1.66, 95% CI 1.24–2.22, P < 0.001, respectively).

Conclusion

There are differences in gastric cancer survival among Asian ethnicities. Future studies addressing varying environmental exposures and molecular expression patterns in gastric cancer are warranted to better understand these disparities in outcome.
Literatur
1.
Zurück zum Zitat Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74–108.PubMedCrossRef Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74–108.PubMedCrossRef
2.
Zurück zum Zitat Hundahl SA, Phillips JL, Menck HR. The National Cancer Data Base Report on poor survival of U.S. gastric carcinoma patients treated with gastrectomy: Fifth Edition American Joint Committee on Cancer staging, proximal disease, and the “different disease” hypothesis. Cancer. 2000;88:921–32.PubMedCrossRef Hundahl SA, Phillips JL, Menck HR. The National Cancer Data Base Report on poor survival of U.S. gastric carcinoma patients treated with gastrectomy: Fifth Edition American Joint Committee on Cancer staging, proximal disease, and the “different disease” hypothesis. Cancer. 2000;88:921–32.PubMedCrossRef
3.
Zurück zum Zitat Theuer CP, Kurosaki T, Ziogas A, Butler J, Anton-Culver H. Asian patients with gastric carcinoma in the United States exhibit unique clinical features and superior overall and cancer specific survival rates. Cancer. 2000;89:1883–92.PubMedCrossRef Theuer CP, Kurosaki T, Ziogas A, Butler J, Anton-Culver H. Asian patients with gastric carcinoma in the United States exhibit unique clinical features and superior overall and cancer specific survival rates. Cancer. 2000;89:1883–92.PubMedCrossRef
4.
Zurück zum Zitat Gill S, Shah A, Le N, Cook EF, Yoshida EM. Asian ethnicity-related differences in gastric cancer presentation and outcome among patients treated at a Canadian cancer center. J Clin Oncol. 2003;21:2070–6.PubMedCrossRef Gill S, Shah A, Le N, Cook EF, Yoshida EM. Asian ethnicity-related differences in gastric cancer presentation and outcome among patients treated at a Canadian cancer center. J Clin Oncol. 2003;21:2070–6.PubMedCrossRef
5.
Zurück zum Zitat Suwanrungruang K, Sriamporn S, Wiangnon S, Rangsrikajee D, Sookprasert A, Thipsuntornsak N, et al. Lifestyle-related risk factors for stomach cancer in northeast Thailand. Asian Pac J Cancer Prev. 2008;9:71–5.PubMed Suwanrungruang K, Sriamporn S, Wiangnon S, Rangsrikajee D, Sookprasert A, Thipsuntornsak N, et al. Lifestyle-related risk factors for stomach cancer in northeast Thailand. Asian Pac J Cancer Prev. 2008;9:71–5.PubMed
6.
Zurück zum Zitat van Loon AJ, Goldbohm RA, van den Brandt PA. Socioeconomic status and stomach cancer incidence in men: results from The Netherlands Cohort Study. J Epidemiol Community Health. 1998;52:166–71.PubMedCrossRef van Loon AJ, Goldbohm RA, van den Brandt PA. Socioeconomic status and stomach cancer incidence in men: results from The Netherlands Cohort Study. J Epidemiol Community Health. 1998;52:166–71.PubMedCrossRef
7.
Zurück zum Zitat Bates JH, Hofer BM, Parikh-Patel A. Cervical cancer incidence, mortality, and survival among Asian subgroups in California, 1990–2004. Cancer. 2008;113:2955–63.PubMedCrossRef Bates JH, Hofer BM, Parikh-Patel A. Cervical cancer incidence, mortality, and survival among Asian subgroups in California, 1990–2004. Cancer. 2008;113:2955–63.PubMedCrossRef
8.
Zurück zum Zitat Kwong SL, Chen MS Jr, Snipes KP, Bal DG, Wright WE. Asian subgroups and cancer incidence and mortality rates in California. Cancer. 2005;104:2975–81.PubMedCrossRef Kwong SL, Chen MS Jr, Snipes KP, Bal DG, Wright WE. Asian subgroups and cancer incidence and mortality rates in California. Cancer. 2005;104:2975–81.PubMedCrossRef
10.
Zurück zum Zitat Kwong SL, Perkins CL, Morris CR, Allen M, Wright WE. Cancer in California 1988–1999 [Internet]. Sacramento CA: California Department of Health Services, Cancer Surveillance Section; 2001. Introduction; [cited 2009 Jun 29]. Available from: http://ccrcal.org/Cancer02/Intro02.pdf. Kwong SL, Perkins CL, Morris CR, Allen M, Wright WE. Cancer in California 1988–1999 [Internet]. Sacramento CA: California Department of Health Services, Cancer Surveillance Section; 2001. Introduction; [cited 2009 Jun 29]. Available from: http://​ccrcal.​org/​Cancer02/​Intro02.​pdf.
11.
Zurück zum Zitat Gregorio DI, Flannery JT, Hansen H. Stomach cancer patterns in European immigrants to Connecticut, United States. Cancer Causes Control. 1992;3:215–21.PubMedCrossRef Gregorio DI, Flannery JT, Hansen H. Stomach cancer patterns in European immigrants to Connecticut, United States. Cancer Causes Control. 1992;3:215–21.PubMedCrossRef
12.
Zurück zum Zitat McCredie M, Coates MS, Ford JM. Cancer incidence in migrants to New South Wales from England, Wales, Scotland and Ireland. Br J Cancer. 1990;62:992–5.PubMed McCredie M, Coates MS, Ford JM. Cancer incidence in migrants to New South Wales from England, Wales, Scotland and Ireland. Br J Cancer. 1990;62:992–5.PubMed
14.
Zurück zum Zitat Coggon D, Osmond C, Barker DJ. Stomach cancer and migration within England and Wales. Br J Cancer. 1990;61:573–4.PubMed Coggon D, Osmond C, Barker DJ. Stomach cancer and migration within England and Wales. Br J Cancer. 1990;61:573–4.PubMed
15.
Zurück zum Zitat Chow WH, Blot WJ, Vaughan TL, Risch HA, Gammon MD, Stanford JL, et al. Body mass index and risk of adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst. 1998;90:150–5.PubMedCrossRef Chow WH, Blot WJ, Vaughan TL, Risch HA, Gammon MD, Stanford JL, et al. Body mass index and risk of adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst. 1998;90:150–5.PubMedCrossRef
16.
Zurück zum Zitat Kim JH, Park SS, Kim J, Boo YJ, Kim SJ, Mok YJ, et al. Surgical outcomes for gastric cancer in the upper third of the stomach. World J Surg. 2006;30:1870–6; discussion 1877–8.PubMedCrossRef Kim JH, Park SS, Kim J, Boo YJ, Kim SJ, Mok YJ, et al. Surgical outcomes for gastric cancer in the upper third of the stomach. World J Surg. 2006;30:1870–6; discussion 1877–8.PubMedCrossRef
17.
Zurück zum Zitat Piso P, Werner U, Lang H, Mirena P, Klempnauer J. Proximal versus distal gastric carcinoma—what are the differences? Ann Surg Oncol. 2000;7:520–5.PubMedCrossRef Piso P, Werner U, Lang H, Mirena P, Klempnauer J. Proximal versus distal gastric carcinoma—what are the differences? Ann Surg Oncol. 2000;7:520–5.PubMedCrossRef
18.
Zurück zum Zitat McCracken M, Olsen M, Chen MS Jr, Jemal A, Thun M, Cokkinides V, et al. Cancer incidence, mortality, and associated risk factors among Asian Americans of Chinese, Filipino, Vietnamese, Korean, and Japanese ethnicities. CA Cancer J Clin. 2007;57:190–205.PubMedCrossRef McCracken M, Olsen M, Chen MS Jr, Jemal A, Thun M, Cokkinides V, et al. Cancer incidence, mortality, and associated risk factors among Asian Americans of Chinese, Filipino, Vietnamese, Korean, and Japanese ethnicities. CA Cancer J Clin. 2007;57:190–205.PubMedCrossRef
19.
Zurück zum Zitat Engel LS, Chow WH, Vaughan TL, Gammon MD, Risch HA, Stanford JL, et al. Population attributable risks of esophageal and gastric cancers. J Natl Cancer Inst. 2003;95:1404–13.PubMed Engel LS, Chow WH, Vaughan TL, Gammon MD, Risch HA, Stanford JL, et al. Population attributable risks of esophageal and gastric cancers. J Natl Cancer Inst. 2003;95:1404–13.PubMed
20.
Zurück zum Zitat Gomez SL, Kelsey JL, Glaser SL, Lee MM, Sidney S. Immigration and acculturation in relation to health and health-related risk factors among specific Asian subgroups in a health maintenance organization. Am J Public Health. 2004;94:1977–84.PubMedCrossRef Gomez SL, Kelsey JL, Glaser SL, Lee MM, Sidney S. Immigration and acculturation in relation to health and health-related risk factors among specific Asian subgroups in a health maintenance organization. Am J Public Health. 2004;94:1977–84.PubMedCrossRef
21.
Zurück zum Zitat A report from the California Asian Pacific Islander Joint Legislative Caucus. In: The State of Asian American, Native Hawaiian and Pacific Islander Health in California Report; 2009. A report from the California Asian Pacific Islander Joint Legislative Caucus. In: The State of Asian American, Native Hawaiian and Pacific Islander Health in California Report; 2009.
22.
Zurück zum Zitat State of Health Insurance in California: Recent trends, future prospects. In: Edition Los Angeles: UCLA Center for Health Policy Research; 2001. State of Health Insurance in California: Recent trends, future prospects. In: Edition Los Angeles: UCLA Center for Health Policy Research; 2001.
23.
Zurück zum Zitat Le H, Ziogas A, Taylor TH, Lipkin SM, Zell JA. Survival of distinct Asian groups among colorectal cancer cases in California. Cancer. 2009;115:259–270.PubMedCrossRef Le H, Ziogas A, Taylor TH, Lipkin SM, Zell JA. Survival of distinct Asian groups among colorectal cancer cases in California. Cancer. 2009;115:259–270.PubMedCrossRef
Metadaten
Titel
Disparities in Gastric Cancer Outcomes Among Asian Ethnicities in the USA
verfasst von
Joseph Kim, MD
Brian Mailey, MD
Maheswari Senthil, MD
Avo Artinyan, MD, MS
Can-Lan Sun, MD, PhD
Smita Bhatia, MD, MPH
Publikationsdatum
01.09.2009
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 9/2009
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0584-4

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