title: Asian Americans and prostate cancer: A nationwide population-based analysis.
abstract: BACKGROUND
  It remains largely unknown if there are racial disparities in outcomes of prostate cancer (PCa) for Asian American and Pacific Islanders (PIs) (AAPIs). We examined differences in diagnosis, management, and survival of AAPI ethnic groups, relative to their non-Hispanic White (NHW) counterparts.
  
  
  METHODS
  Patients (n = 891,100) with PCa diagnosed between 1988 and 2010 within the surveillance, epidemiology, and end results database were extracted and stratified by ethnic group: Chinese, Japanese, Filipino, Hawaiian, Korean, Vietnamese, Asian Indian/Pakistani, PI, and Other Asian. The effect of ethnic group on stage at presentation, rates of definitive treatment, and PCa-specific mortality was assessed. The severity at diagnosis was defined as: localized (TxN0M0), regional (TxN1M0), or metastatic (TxNxM1).
  
  
  RESULTS
  Relative to NHWs, Asian Indian/Pakistani, Filipino, Hawaiian, and PI men had significantly worse outcomes. Filipino (odds ratio [OR] = 1.38, 95% CI: 1.27-1.51), Hawaiian, (OR = 1.70, 95% CI: 1.41-2.04), Asian Indian/Pakistani (OR = 1.37, 95% CI: 1.15-1.64), and PI men (OR = 1.90, 95% CI: 1.46-2.49) were more likely to present with metastatic PCa (P<0.001). In patients with localized PCa, Filipino men were less likely to receive definitive treatment (OR = 0.91; 95% CI: 0.84-0.97; P = 0.005). Most AAPI groups had lower rates of PCa death except for Hawaiian (hazard ratio = 1.52; 95% CI: 1.30-1.77; P<0.0001) and PI men (hazard ratio = 1.43; 95% CI: 1.12-1.82; P<0.0001).
  
  
  CONCLUSIONS
  Compared with NHWs, AAPI groups were more likely to present with advanced PCa but had better cancer-specific survival. Conversely, Hawaiian and PI men were at greater risk for PCa-specific mortality. Given the different cancer profiles, our results show that there is a need for disaggregation of AAPI data.
authors.affiliation: Department of Medicine, Harvard Medical School, Boston, MA.
authors.forename: Grace F
authors.initials: GF
authors.lastname: Chao
authors.affiliation: Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA.
authors.forename: Nandita
authors.initials: N
authors.lastname: Krishna
authors.affiliation: Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA.
authors.forename: Ayal A
authors.initials: AA
authors.lastname: Aizer
authors.affiliation: Center for Outcomes Research, Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI.
authors.forename: Deepansh
authors.initials: D
authors.lastname: Dalela
authors.affiliation: Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA.
authors.forename: Julian
authors.initials: J
authors.lastname: Hanske
authors.affiliation: Center for Outcomes Research, Analytics and Evaluation, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI.
authors.forename: Hanhan
authors.initials: H
authors.lastname: Li
authors.affiliation: Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA.
authors.forename: Christian P
authors.initials: CP
authors.lastname: Meyer
authors.affiliation: Urology Institute, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH.
authors.forename: Simon P
authors.initials: SP
authors.lastname: Kim
authors.affiliation: Department of Medicine, Harvard Medical School, Boston, MA.
authors.forename: Brandon A
authors.initials: BA
authors.lastname: Mahal
authors.affiliation: Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA.
authors.forename: Gally
authors.initials: G
authors.lastname: Reznor
authors.affiliation: Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA.
authors.forename: Marianne
authors.initials: M
authors.lastname: Schmid
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.
authors.forename: Toni K
authors.initials: TK
authors.lastname: Choueiri
authors.affiliation: Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Nguyen
authors.affiliation: Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA.
authors.forename: Michael
authors.initials: M
authors.lastname: O'Leary
authors.affiliation: Division of Urologic Surgery and Center for Surgery and Public Health, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA. Electronic address: trinh.qd@gmail.com.
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
mesh_terms: D000368:Aged; D001213:Asian / Q000706:statistics & numerical data*; D002681:China / Q000208:ethnology; D006801:Humans; D007564:Japan / Q000208:ethnology; D007723:Korea / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010679:Philippines / Q000208:ethnology; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000208:ethnology* / Q000628:therapy; D018426:SEER Program / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014481:United States; D014744:Vietnam / Q000208:ethnology
keywords: Outcomes; Prostate cancer; Racial disparities; SEER