Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2024

26-10-2023 | Pancreatic Cancer | Pancreatic Tumors

Disparities in Pancreatic Cancer Outcomes in the Disaggregated Asian American Population

Authors: Keshav Kooragayala, MD, Johanna Lou, MD, John Dibato, PhD, Young Ki Hong, MD, MPH

Published in: Annals of Surgical Oncology | Issue 2/2024

Login to get access

Abstract

Background

The Asian American, Native Hawaiian, and Pacific Islander (AANHPI) population is among the fastest-growing population in the USA. However, this is not reflected in scientific research, in which ethnic groups are often combined. We identified trends in treatment and outcomes for pancreatic cancer in a disaggregated AANHPI population. We hypothesize that patients from different AANHPI groups have differences in survival.

Patients and Methods

A retrospective analysis of the National Cancer Database between 2010 and 2019 identified patients treated for pancreatic cancer. We identified demographic factors for patients of Caucasian, African American, and disaggregated Asian subpopulations. Survival curves were generated and multivariate analysis was performed to help determine which factors impacted overall survival.

Results

A total of 296,448 patients met the inclusion criteria. Of those, 8568 (3%) patients were Asian. Median survival of AANHPI patients was 11.3 months, as compared with Caucasians (8.9 months) and African Americans (8.1 months) (p < 0.0001). Asian Indians had the highest median survival (14.3 months), whereas the Japanese subpopulation had the lowest (7.6 months) (p < 0.0001). There were significant differences in median survival between the different AANHPI subpopulations irrespective of stage. Multivariate analysis demonstrated that belonging to an AANHPI racial/ethnic group, excluding Japanese and Filipino, was associated with decreased risk of overall mortality.

Discussion

Significant differences were identified in the overall median survival for patients with pancreatic cancer between AANHPI subpopulations. Disparities in socioeconomic factors may have played a role in overall survival. This study highlights the need to include disaggregated data in future studies to subdue disparities in cancer care for patients.
Appendix
Available only for authorised users
Literature
1.
Torre LA, Sauer AM, Chen MS Jr, Kagawa-Singer M, Jemal A, Siegel RL. Cancer statistics for Asian Americans, Native Hawaiians, and Pacific Islanders, 2016: converging incidence in males and females. CA Cancer J Clin. 2016;66(3):182–202.CrossRefPubMedPubMedCentral
2.
Chawla N, Breen N, Liu B, Lee R, Kagawa-Singer M. Asian American women in California: a pooled analysis of predictors for breast and cervical cancer screening. Am J Public Health. 2015;105(2):e98–109.CrossRefPubMedPubMedCentral
3.
Thompson CA, Gomez SL, Chan A, et al. Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans. Cancer Epidemiol Biomarkers Prev. 2014;23(11):2208–17.CrossRefPubMedPubMedCentral
4.
Babey SH, Ponce NA, Etzioni DA, Spencer BA, Brown ER, Chawla N. Cancer screening in California: Racial and ethnic disparities persist. Policy Brief UCLA Cent Health Policy Res. 2003(PB2003-4):1-6.
5.
Sentell T, Braun KL, Davis J, Davis T. Health literacy and meeting breast and cervical cancer screening guidelines among Asians and whites in California. Springerplus. 2015;4:432.CrossRefPubMedPubMedCentral
6.
Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7–33.CrossRefPubMed
7.
Liu L, Zhang J, Deapen D, et al. Differences in pancreatic cancer incidence rates and temporal trends across Asian subpopulations in California (1988–2015). Pancreas. 2019;48(7):931–3.CrossRefPubMedPubMedCentral
8.
9.
Mallin K, Browner A, Palis B, et al. Incident cases captured in the national cancer database compared with those in U.S. population based central cancer registries in 2012–2014. Ann Surg Oncol. 2019;26(6):1604–12.CrossRefPubMed
10.
Liu XR, Pawitan Y, Clements M. Parametric and penalized generalized survival models. Stat Methods Med Res. 2018;27(5):1531–46.CrossRefPubMed
11.
12.
Neoptolemos JP, Stocken DD, Friess H, et al. A randomized trial of chemoradiotherapy and chemotherapy after resection of pancreatic cancer. N Engl J Med. 2004;350(12):1200–10.CrossRefPubMed
13.
Conroy T, Hammel P, Hebbar M, et al. FOLFIRINOX or gemcitabine as adjuvant therapy for pancreatic cancer. N Engl J Med. 2018;379(25):2395–406.CrossRefPubMed
14.
Hoehn RS, Rieser CJ, Winters S, et al. A pancreatic cancer multidisciplinary clinic eliminates socioeconomic disparities in treatment and improves survival. Ann Surg Oncol. 2021;28(5):2438–46.CrossRefPubMedPubMedCentral
15.
16.
Fong ZV, Loehrer AP, Fernandez-Del Castillo C, et al. Potential impact of a volume pledge on spatial access: a population-level analysis of patients undergoing pancreatectomy. Surgery. 2017;162(2):203–10.CrossRefPubMed
17.
18.
Blackhall LJ, Murphy ST, Frank G, Michel V, Azen S. Ethnicity and attitudes toward patient autonomy. JAMA. 1995;274(10):820–5.CrossRefPubMed
19.
Tan NQP, Maki KG, Lopez-Olivo MA, Geng Y, Volk RJ. Cultural influences on shared decision-making among Asian Americans: a systematic review and meta-synthesis of qualitative studies. Patient Educ Couns. 2023;106:17–30.CrossRefPubMed
20.
Zheng L. To dismantle Anti-Asian racism, we must understand its roots. Harv Bus Rev. 2021.
21.
Chen MS, Lee RJ, Madan RA, et al. Charting a path towards Asian American cancer health equity: a way forward. J Natl Cancer Inst. 2022;114(6):792–9.CrossRefPubMed
22.
Sausen M, Phallen J, Adleff V, et al. Clinical implications of genomic alterations in the tumour and circulation of pancreatic cancer patients. Nat Commun. 2015;6:7686.CrossRefPubMed
23.
Bailey P, Chang DK, Nones K, et al. Genomic analyses identify molecular subtypes of pancreatic cancer. Nature. 2016;531(7592):47–52.CrossRefPubMed
24.
Qian ZR, Rubinson DA, Nowak JA, et al. Association of alterations in main driver genes with outcomes of patients with resected pancreatic ductal adenocarcinoma. JAMA Oncol. 2018;4(3):e173420.CrossRefPubMed
25.
Yang Y, Ding Y, Gong Y, et al. The genetic landscape of pancreatic head ductal adenocarcinoma in China and prognosis stratification. BMC Cancer. 2022;22(1):186.CrossRefPubMedPubMedCentral
26.
Santos PMG, Dee EC, Deville C Jr. Confronting anti-Asian racism and health disparities in the era of COVID-19. JAMA Health Forum. 2021;2(9):e212579.CrossRefPubMed
27.
Concepcion J, Yeager M, Alfaro S, et al. Trends of cancer screenings, diagnoses, and mortalities during the COVID-19 pandemic: implications and future recommendations. Am Surg. 2023;89(6):2276–83.CrossRefPubMed
Metadata
Title
Disparities in Pancreatic Cancer Outcomes in the Disaggregated Asian American Population
Authors
Keshav Kooragayala, MD
Johanna Lou, MD
John Dibato, PhD
Young Ki Hong, MD, MPH
Publication date
26-10-2023
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 2/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-14454-8

Other articles of this Issue 2/2024

Annals of Surgical Oncology 2/2024 Go to the issue

Hepatobiliary Tumors

Phase I Safety and Feasibility Pilot of Hepatic Artery Infusion Chemotherapy in a Rural Catchment Area Using The Codman Vascular Catheter with The Medtronic SynchroMed II Pump for Intrahepatic Cancers

ASO Visual Abstract

ASO Visual Abstract: Phase I Safety and Feasibility Pilot of Hepatic Artery Infusion Chemotherapy in a Rural Catchment Area Using the Codman Vascular Catheter with the Medtronic Synchromed II Pump for Intrahepatic Cancers

ASO Visual Abstract

ASO Visual Abstract: A Comparison of Clinicopathologic Outcomes and Patterns of Lymphatic Spread Across Neoadjuvant Chemotherapy, Neoadjuvant Chemoradiotherapy and Neoadjuvant Immunochemotherapy in Locally Advanced Esophageal Squamous Cell Carcinoma

ASO Author Reflections

ASO Author Reflections: Impact of Neutrophil Extracellular Traps on Extrahepatic Cholangiocarcinomas

ASO Author Reflections

ASO Author Reflections: The Role of Neoadjuvant Chemotherapy Among Elderly Patients with Locally Advanced Gastric Cancer

ASO Author Reflections

ASO Author Reflections: Realtime Near-infrared Autofluorescence Based Overlay Imaging as Intraoperative Tool for Parathyroid Gland Localization: Routinized Application and Standards in Clinical Practice