American Journal of Public Health
Volume 100, Issue 5, 2010, Pages 861-869

Disparities in breast cancer survival among Asian women by ethnicity and immigrant status: A population-based study (Article)

Gomez S.L. , Clarke C.A. , Shema S.J. , Chang E.T. , Keegan T.H.M. , Glaser S.L.
  • a Northern California Cancer Center, 2201 Walnut Ave, Fremont, CA 94538, United States, Department of Health Research and Policy, School of Medicine, Stanford University, Palo Alto, CA, United States
  • b Northern California Cancer Center, 2201 Walnut Ave, Fremont, CA 94538, United States
  • c Northern California Cancer Center, 2201 Walnut Ave, Fremont, CA 94538, United States
  • d Northern California Cancer Center, 2201 Walnut Ave, Fremont, CA 94538, United States, Department of Health Research and Policy, School of Medicine, Stanford University, Palo Alto, CA, United States
  • e Northern California Cancer Center, 2201 Walnut Ave, Fremont, CA 94538, United States, Department of Health Research and Policy, School of Medicine, Stanford University, Palo Alto, CA, United States
  • f Northern California Cancer Center, 2201 Walnut Ave, Fremont, CA 94538, United States, Department of Health Research and Policy, School of Medicine, Stanford University, Palo Alto, CA, United States

Abstract

Objectives. We investigated heterogeneity in ethnic composition and im migrant status among US Asians as an explanation for disparities in breast cancer survival. Methods. We enhanced data from the California Cancer Registry and the Surveillance, Epidemiology, and End Results program through linkage and imputation to examine the effect of immigrant status, neighborhood socioeconomic status, and ethnic enclave on mortality among Chinese, Japanese, Filipino, Korean, South Asian, and Vietnamese women diagnosed with breast cancer from 1988 to 2005 and followed through 2007. Results. US-born women had similar mortality rates in all Asian ethnic groups except the Vietnamese, who had lower mortality risk (hazard ratio [HR] = 0.3; 95% confidence interval [CI] = O.1, 0.9). Except for Japanese women, all foreign-born women had higher mortality than did US-born Japanese, the reference group. HRs ranged from 1.4 (95% Cl = 1.2, 1.7) among Koreans to 1.8 (95% Cl = 1.5, 2.2) among South Asians and Vietnamese. Little of this variation was explained by differences in disease characteristics. Conclusions. Survival after breast cancer is poorer among foreign- than USborn Asians. Research on underlying factors is needed, along with increased awareness and targeted cancer control.

Author Keywords

[No Keywords available]

Index Keywords

proportional hazards model Registries Proportional Hazards Models survival survival analysis health disparity Health Status Disparities register human middle aged Aged ethnology United States Humans Breast Neoplasms California Asian Americans Emigrants and Immigrants Asian American breast tumor female Article adult migration mortality
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-77951218493&doi=10.2105%2fAJPH.2009.176651&partnerID=40&md5=97c4ec2477e69f90f97c2120f8e9d2dd
DOI: 10.2105/AJPH.2009.176651
ISSN: 00900036
Cited by: 74
Original Language: English