Ovarian cancer survival population differences: a "high resolution study" comparing Philippine residents, and Filipino-Americans and Caucasians living in the US.
BACKGROUND
In contrast to most other forms of cancer, data from some developing and developed countries show surprisingly similar survival rates for ovarian cancer. We aimed to compare ovarian cancer survival in Philippine residents, Filipino-Americans and Caucasians living in the US, using a high resolution approach, taking potential differences in prognostic factors into account.


METHODS
Using databases from the SEER 13 and from the Manila and Rizal Cancer Registries, age-adjusted five-year absolute and relative survival estimates were computed using the period analysis method and compared between Filipino-American ovarian cancer patients with cancer patients from the Philippines and Caucasians in the US. Cox proportional hazards modelling was used to determine factors affecting survival differences.


RESULTS
Despite more favorable distribution of age and cancer morphology and similar stage distribution, 5-year absolute and relative survival were lower in Philippine residents (Absolute survival, AS, 44%, Standard Error, SE, 2.9 and Relative survival, RS, 49.7%, SE, 3.7) than in Filipino-Americans (AS, 51.3%, SE, 3.1 and RS, 54.1%, SE, 3.4). After adjustment for these and additional covariates, strong excess risk of death for Philippine residents was found (Relative Risk, RR, 2.45, 95% confidence interval, 95% CI, 1.99-3.01). In contrast, no significant differences were found between Filipino-Americans and Caucasians living in the US.


CONCLUSIONS
Multivariate analyses disclosed strong survival disadvantages of Philippine residents compared to Filipino-American patients, for which differences in access to health care might have played an important role. Survival is no worse among Filipino-Americans than among Caucasians living in the US.
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. m.redaniel@dkfz-heidelberg.de
Maria Theresa M
MT
Redaniel
Adriano
A
Laudico
Maria Rica
MR
Mirasol-Lumague
Adam
A
Gondos
Gemma Leonora
GL
Uy
Jean Ann
JA
Toral
Doris
D
Benavides
Hermann
H
Brenner
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000208:ethnology* / Q000401:mortality*; D010679:Philippines / Q000208:ethnology; D018426:SEER Program; D013534:Survival; D014481:United States; D044465:White People; D055815:Young Adult