Lee Alice W, Poynor Valerie, Siddiqui Sannia
Department of Public Health, California State University, Fullerton, 800 N. State College Blvd., KHS-127, Fullerton, CA 92831, USA.
Department of Mathematics, California State University, Fullerton, 154 McCarthy Hall, MH-104E, Fullerton, CA 92834, USA.
Gynecol Oncol. 2024 Dec;191:292-298. doi: 10.1016/j.ygyno.2024.10.017. Epub 2024 Nov 2.
Asian Americans have the highest ovarian cancer survival across the major racial groups although it is unclear whether this survival advantage is observed when each Asian ethnic subgroup is examined separately. Disaggregated survival analyses of this heterogeneous population is needed to ensure ethnic-specific disparities are not overlooked.
Data on ovarian cancer cases diagnosed from 2006 through 2020 from the Surveillance, Epidemiology, and End Results (SEER) Program were analyzed. Age-standardized five-year cause-specific survival was calculated for Non-Hispanic Whites and seven Asian ethnic subgroups in the U.S. (Asian Indian/Pakistani, Chinese, Filipino, Hawaiian/Pacific Islander, Japanese, Korean, Vietnamese) by stage and histotype. Multivariable Cox regression analyses using a weighted approach were conducted to calculate average hazard ratios (AHRs) and 95 % confidence intervals (CIs) to quantify the risk of ovarian cancer death comparing each Asian ethnic subgroup to Non-Hispanic Whites.
Hawaiian/Pacific Islanders were the only Asian subgroup to show lower five-year cause-specific survival than Non-Hispanic Whites (44.99 % versus 47.90 %, respectively); Asian Indian/Pakistanis showed the highest survival (56.12 %). After adjusting for sociodemographic, tumor, and treatment characteristics, Asian Indian/Pakistani ovarian cancer patients were 17 % less likely to die from their disease whereas Hawaiian/Pacific Islander patients were 28 % more likely to die when compared to Non-Hispanic Whites (AHR = 0.83, 95 % CI 0.75-0.92 and AHR = 1.28, 95 % CI 1.07-1.53, respectively).
There are clear ethnic-specific survival disparities among Asian American ovarian cancer patients that are missed when the population is examined as a single group, further highlighting the need for data disaggregation in future ovarian cancer research.
亚裔美国人在主要种族群体中卵巢癌生存率最高，不过尚不清楚分别审视每个亚裔亚群体时是否也存在这种生存优势。需要对这个异质性群体进行分类生存分析，以确保不会忽视特定种族的差异。
分析了监测、流行病学和最终结果（SEER）项目中2006年至2020年诊断出的卵巢癌病例数据。按阶段和组织类型计算了美国非西班牙裔白人以及七个亚裔亚群体（亚裔印度人/巴基斯坦人、华人、菲律宾人、夏威夷人/太平洋岛民、日本人、韩国人、越南人）的年龄标准化五年病因特异性生存率。采用加权方法进行多变量Cox回归分析，计算平均风险比（AHRs）和95%置信区间（CIs），以量化每个亚裔亚群体与非西班牙裔白人相比的卵巢癌死亡风险。
夏威夷人/太平洋岛民是唯一一个五年病因特异性生存率低于非西班牙裔白人的亚裔亚群体（分别为44.99%和47.90%）；亚裔印度人/巴基斯坦人的生存率最高（56.12%）。在调整了社会人口学、肿瘤和治疗特征后，与非西班牙裔白人相比，亚裔印度/巴基斯坦卵巢癌患者死于该病的可能性低17%，而夏威夷/太平洋岛民患者死亡可能性高28%（AHR分别为0.83，95%CI为0.75 - 0.92和AHR为1.28，95%CI为1.07 - 1.53）。
美国亚裔卵巢癌患者存在明显的种族特异性生存差异，将该群体作为一个整体审视时会忽略这些差异，这进一步凸显了未来卵巢癌研究中数据分类的必要性。
