Abstract B108: Disparities in clinical and demographic characteristics among Asian/Pacific Islander and non-Hispanic White newly diagnosed lung cancer patients
Authors: Patel Parth Bhargav , Alpert Naomi , Flores Raja , Taioli Emanuela 
Published: September 2020

Purpose: Racial disparities persist among patients with lung cancer (LC), and are well documented among Non-Hispanic Whites (NHW), Blacks, and Hispanics. However they have not been adequately studied among the ethnic subgroups of Asian/Pacific Islanders (API). API populations are heterogeneous in many ways, including country of origin, cultural diversity, health behaviors, and health outcomes, but they are often treated as a single group. The goal of this study is to compare the clinical and demographic characteristics at LC diagnosis between API subgroups and NHW patients.

Methods: NHW and API patients aged ≥ 18 years diagnosed with malignant LC from 1990 to 2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) Program. API population was divided into 8 ethnic subgroups (ES): Filipino, Chinese, Japanese, Asian Indian/Pakistani, Korean, Vietnamese, Hawaiian/Pacific Islander, and Other. Multivariable logistic regression and multinomial logistic regression models with NHW as the reference were used to estimate odds ratios (OR) and 95% confidence intervals (CI) to assess independent associations of LC patient clinical and demographic factors with API and ES.

Results: There were 522,702 NHW and 41,479 API LC patients. API was significantly younger (ORadj: 0.53, 95% CI: 0.49-0.58 for ≥80 vs. ≤39 years) than NHW, with differences according to ES (range of effects: ORadj [Asian Indian/Pakistani]: 0.10, 95% CI: 0.07-0.14; ORadj [Japanese]: 2.73, 95% CI: 1.91-3.92). API patients and ES subgroups were less likely to be female (ORadj: 0.84, 95% CI: 0.83-0.86); API patients were less likely to be never married (ORadj: 0.71, 95% CI: 0.69-0.74), and so was for ES except for Hawaiian/Pacific Islanders, who were more likely to be never married (ORadj: 1.15, 95% CI: 1.05-1.27). API were more likely to be diagnosed at a later stage (ORadj: 1.31, 95% CI: 1.27-1.35 for stage IV vs. stage I); this was similar across ES. API patients were significantly less likely to be diagnosed with a squamous cell carcinoma (ORadj: 0.54, 95% CI: 0.52-0.55, compared to adenocarcinoma); effects ranged from ORadj[Vietnamese]: 0.37, 95% CI: 0.33-0.41 to ORadj [Hawaiian/Pacific Islander]: 0.89, 95% CI: 0.82-0.97.

Conclusion: At diagnosis, significant disparities in demographic and clinical characteristics exist between NHW and API patients overall, as well as across the eight major API ethnic subgroups. These findings indicate that treating API patients as a single population may miss crucial biological, environmental and behavioral differences. It may be beneficial to view these subgroups separately when developing strategies for prevention and efficacious treatment.

Citation Format: Parth Bhargav Patel, Naomi Alpert, Raja Flores, Emanuela Taioli. Disparities in clinical and demographic characteristics among Asian/Pacific Islander and non-Hispanic White newly diagnosed lung cancer patients [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr B108.