P206 Factors associated with survival differences in immigrant Asians versus USA-born Asians with uterine cancer

Abstract

<h3>Background</h3> We compared clinicopathological characteristics and survival outcomes in immigrant Asians versus USA-born Asians with endometrial cancer. <h3>Methods</h3> Data from 2001 through 2009 were abstracted from the Surveillance, Epidemiology, and End Results Program (SEER) database. Chi-squared, Kaplan–Meier estimates, and Cox proportional hazards regression methods were used for statistical analyses. <h3>Findings</h3> Of 4834 Asians with endometrial cancer, 1860 (38%) were immigrants from Asian countries. The median age was 56years (range 19–96). Of the immigrants, 51% (<i>n</i>=953) were from the Philippines and Pacific Islands, 19% (350) from China, 13% (235) from southeast Asia, 6% (117) from India, 6% (102) from Korea, and 5% (97) from Japan. In the overall study group, 16% had high disease stage and 21% had high disease grade. 3767 (78%) of patients had endometrioid, 93 (2%) had clear cell, and 285 (6%) had papillary serous histology. Compared with those born in the USA, immigrant Asians were more likely to have higher stage (33% versus 28%, <i>p</i><0.01) and higher grade disease (24% versus 15%, <i>p</i><0.01) disease. Immigrant Asians were also more likely to have serous (7.4% versus 5.0% <i>p</i><0.01) and clear cell histologies (2.2% versus 1.7%, <i>p</i><0.01). The 5-year disease-specific survival rate for immigrant versus US-born Asians was 66% versus 77% (<i>p</i><0.01). 5-year survival was 77% for immigrant Asians from the Philippines and Pacific Islands, 74% for those from China, 81% for those from southeast Asia, 68% for those from India, 68% for those from Japan, and 83% for those from Korea (<i>p</i>=0.10). On multivariate analysis, age (hazard ratio [HR] 1.05, confidence interval [CI] 1.04–1.06, <i>p</i><0.01), lower disease stage (HR 0.15, CI 0.12–0.19, <i>p</i><0.01), and lower disease grade (HR 0.44, CI 0.35–0.55, <i>p</i><0.01) were important predictors of survival. After adjusting for these factors, immigration status no longer predicted survival. <h3>Interpretation</h3> Immigrant Asians with endometrial cancer have poorer survival compared with their US-born counterparts. This may be attributed to a higher proportion of advanced stage, poor histologic subtypes, and higher grade of disease.