Gynecologic Oncology
Volume 149, Issue 1, 2018, Pages 63-69

The impact of nativity on cervical cancer survival in the public hospital system of Queens, New York (Article)

Hagopian G.S.* , Lieber M. , Dottino P.R. , Margaret Kemeny M. , Li X. , Overbey J. , Clark L.-D. , Beddoe A.M.
  • a Department of Obstetrics and Gynecology, Elmhurst Hospital Center, Elmhurst, Queens, NY, United States, Department of Obstetrics and Gynecology, Queens Hospital Center, Jamaica, Queens, NY, United States, Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States, Queens Cancer Center, Queens Hospital Center, Jamaica, Queens, NY, United States
  • b Division of Global Health, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States
  • c Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States
  • d Queens Cancer Center, Queens Hospital Center, Jamaica, Queens, NY, United States, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States
  • e Department of Radiation Oncology, Queens Hospital Center, United States, Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
  • f Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States
  • g Department of Obstetrics and Gynecology, Queens Hospital Center, Jamaica, Queens, NY, United States
  • h Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States, Division of Global Health, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States

Abstract

Objective: We studied cervical cancer patients who presented to the Public Hospital System in ethnically-diverse Queens, New York from 2000 to 2010 with the purpose of examining the relationship between nativity (birthplace) and survival. Methods: A retrospective review of tumor registries was used to identify patients diagnosed with cervical cancer between January 1, 2000 and December 31, 2010. Using electronic medical records, data from 317 patients were available for this analysis. Results: The majority of patients were born outside the United States (US) (85.5% versus 14.5%). One hundred patients (31.5%) were born in Latin America, 105 in the Caribbean Islands (33.1%), 48 in Asia (15.1%), 8 in the South Asia (2.5%), 10 in Russia/Eastern Europe (3.2%) and 46 (14.5%) in the United States. Patients presented at varying stages of disease: 51.4% at stage I, 19.6% at stage II, 19.6% at stage III, and 8.5% at stage IV. Kaplan-Meier estimated survival curves stratified by birthplace demonstrated significant differences in survival distributions among the groups using the log-rank test (P < 0.0001). The most favorable survival curves were observed among patients born in Latin America and Asia whereas the least favorable was demonstrated in US-born patients. Time to death was analyzed using the Cox proportional hazards model. Adjusting for age at diagnosis, insurance status, stage and treatment modality, nodal metastases and hydronephrosis, birthplace was significantly associated with survival time (P < 0.0001). Conclusion: An immigrant health paradox was defined for foreign-born Latino and Asian patients presenting with cervical cancer to the Public Hospital System of Queens, New York as patients born in Latin America and Asia were less likely to die at any given time compared to those born in the United States. © 2017 Elsevier Inc.

Author Keywords

Nativity Cervical cancer Birthplace Public hospital

Index Keywords

medical record review West Indies South and Central America Europe, Eastern proportional hazards model Latin America Hospitals, Public Proportional Hazards Models health disparity Health Status Disparities health insurance human epidemiology middle aged Asia population group cancer survival statistics and numerical data Population Groups priority journal cancer staging overall survival cancer chemotherapy cancer screening Eastern Europe ethnology United States Humans migrant New York male Emigrants and Immigrants cancer radiotherapy female uterine cervix carcinoma uterine cervix adenocarcinoma hydronephrosis lymph node metastasis antineoplastic agent public hospital cancer therapy Article Retrospective Studies major clinical study adult uterine cervix cancer New York City hysterectomy Uterine Cervical Neoplasms uterine cervix tumor retrospective study mortality Russian Federation Caribbean Islands
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85044134904&doi=10.1016%2fj.ygyno.2017.11.035&partnerID=40&md5=83313fe9b512cb0a4fd09c6eec7f03c6
DOI: 10.1016/j.ygyno.2017.11.035
ISSN: 00908258
Original Language: English