Abstract 35: Common themes for common cancers - trends in survival by disaggregated Hispanic ethnicity

Abstract

Abstract Background: US Hispanic patients tend to have lower incidence and mortality among many cancers, yet these aggregated data do not reflect cultural and ancestral diversity of Hispanic patients. For example, we previously reported that Dominican pancreatic cancer patients had improved survival compared to other Hispanic groups. We sought to characterize survival differences among disaggregated Hispanic ethnic groups with the deadliest cancers in the US. Methods: Breast, prostate, lung, liver, pancreas, colon, rectosigmoid, and rectal cancer cases among Non-Hispanic White (NHW), Mexican, Puerto Rican, Cuban, South/Central American, Dominican or “Hispanic Not Otherwise Specified” were extracted from the National Cancer Database (2010-2015). Analysis was restricted to patients with only one primary cancer diagnosis and the most prevalent histologies. Restricted mean survival times were determined. Survival across groups was compared using Cox proportional hazard models. Multivariable analysis included socioeconomic, pathologic, comorbidity, and treatment factors. Results: Across all cancers, Hispanic patients [54.7 months (95% CI: 54.0-55.4)] had significantly longer survival compared to NHW patients [50.5 months (95% CI: 50.5-51.0)], with Dominican patients having the longest survival [65.5 months (95% CI: 60.5-70.5)]. On univariable analysis, Dominican patients had lower risk of death across all cancers compared to NHW (HR 0.56, p<0.0001). When similarly analyzed by individual cancer type, Dominican patients had the lowest risk of death among each cancer except lung squamous cell carcinoma (SCC). On multivariable analysis, hazard of death was even lower for Dominican patients (HR 0.48, p<0.0001) compared to NHW patients across all cancer types. After adjusting for covariates, similar trends persisted for Dominican patients across all cancer types: breast (HR 0.46, p<0.0001), prostate (HR 0.42, p<0.0001), pancreatic adenocarcinoma (HR 0.49, p<0.0001), hepatocellular carcinoma (HR 0.54, p<0.0001), lung adenocarcinoma (HR 0.45, p<0.0001), lung SCC (HR 0.67, p=0.008), colon (HR 0.62, p=0.0004), rectosigmoid (HR 0.39, p=0.023), and rectal adenocarcinomas (HR 0.46, p=0.005). Lung SCC was the only cancer that Dominican patients trailed another group in lowest hazard of death (Cuban patients’ HR 0.64). Conclusion: Patients of Dominican descent experience improved survival compared to NHW and other Hispanic ethnic groups across nearly all common cancer types, regardless of socioeconomic factors, cancer stage and pathology, and treatment. Genomic diversity and cultural factors may influence differential survival among Hispanic groups. It is critical to accurately record data on disaggregated Hispanic ethnicity and to promote inclusion of a diverse patients in cancer research. This may in turn elucidate differences in carcinogenesis and treatment response. Citation Format: Andrea N. Riner, Kelly M. Herremans, Daniel Neal, Jose G. Trevino. Common themes for common cancers - trends in survival by disaggregated Hispanic ethnicity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 35.