Asian American sub-ethnic disparities and trends in epithelial ovarian cancer diagnosis, treatment and survival

ABSTRACT

Objectives

Studies on ovarian cancer (OC) diagnosis, treatment and survival across disaggregated Asian sub-ethnic groups are sparse. Few studies have also conducted trend analyses of these outcomes within and across Asian groups.

Methods

Using logistic, Cox, and Joinpoint regression analyses of the 2000–2018 Surveillance, Epidemiology, and End Results (SEER) data, we examined disparities and trends in OC advanced stage diagnosis, receipt of treatments and the 5-year cause-specific survival across seven Asian sub-ethnic groups.

Results

There were 6491 OC patients across seven Asian sub-ethnic groups (mean [SD] age, 57.29 [13.90] years). There were 1583(24.39%) Filipino, 1183(18.23%) Chinese, and 761(11.72%) Asian Indian or Pakistani (AIP) patients. The majority (52.49%) were diagnosed with OC with at an advanced stage. AIP were more likely to have advanced stage diagnosis than other subgroups (ORs, 95%CIs: 0.77, 0.62−0.96 [Filipino]; 0.76, 0.60−0.95 [Chinese]; 0.71, 0.54−0.94 [Japanese]; 0.74, 0.56−0.98 [Vietnamese] and 0.66, 0.53−0.83 [Other Asians]). The Filipinos were least likely to receive surgery but most likely to undergo chemotherapy. Japanese patients had the worst 5-year OC cause-specific survival (50.29%, 95%CI: 46.20%−54.74%). Based on the aggregated analyses, there was a significantly decreased trend in advanced-stage diagnosis and an increased trend in receipt of chemotherapy. Trends in OC outcomes for several subethnicities differed from those observed in aggregated analyses.

Conclusion

In this cohort study of 6491 patients, OC diagnosis, treatment, survival, and trends differed across Asian American ethnic subgroups. Such differences must be considered in future research and interventions to ensure all Asian American subethnicities equally benefit from the advancements in OC care and control.

KEYWORDS:

• Ovarian cancer
• Asian American
• sub-ethnic disparities
• diagnosis
• treatment and survival
• trend analysis

Sustainable Development Goals:

• SDG 10: Reduced inequalities

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data used in this study are available from the National Cancer Institute’s SEER program (https://seer.cancer.gov).

Additional information

Funding

This work was supported by the Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang: [Grant Number 2019R01007].