Asian And Pacific Islander Research Articles

Abstract 4784: PATHFINDER 2: A prospective study to evaluate safety and performance of a multi-cancer early detection test in a population setting

Abstract Background: Multi-cancer early detection (MCED) tests are being established as a novel approach to screen for multiple cancer types with one test. A blood-based MCED test using cell-free DNA targeted methylation patterns to detect a shared cancer signal and predict a cancer signal origin (CSO) has demonstrated feasibility. An initial return of results study (PATHFINDER; NCT04241796) reported performance of a refined version of the MCED test, including a 43.1% positive predictive value (PPV), 98.5% negative predictive value (NPV), 99.5% specificity, and 88.0% CSO accuracy. To build on this work, the PATHFINDER 2 study (NCT05155605) will evaluate safety and performance of the MCED test in larger, more diverse populations. Methods: PATHFINDER 2 is a prospective, multicenter, interventional study. Participants ≥50 years of age will be enrolled, with specific targets to improve diversity (age, sex, race/ethnicity) and few exclusions due to comorbid conditions. Exclusion criteria include current clinical suspicion of cancer or recent cancer/treatment (within 3 years). Participants will undergo blood draw for MCED testing, followed by return of results (cancer signal detection and CSO) to the investigator and diagnostic evaluations if a cancer signal is detected. A confirmatory PET-CT scan will be performed when CSO-directed workups do not result in a cancer diagnosis. Participants will be followed for approximately 3 years. Primary endpoints include 1) MCED test safety in terms of diagnostic testing triggered by a positive result (number/type of procedures and adverse events) and 2) test performance (PPV, NPV, specificity, sensitivity, CSO accuracy, cancer detection rate and number needed to screen). Secondary endpoints include participant reported outcomes (eg, anxiety), utilization of guideline-recommended cancer screening, and cancer detection rate of confirmatory PET-CT, amongst others. The study plans to enroll approximately 35,000 participants across North America. Sites were selected based on geographic location, catchment area demographics, and practice setting (academic vs non-academic). Enrollment targets for age, sex and race/ethnicity (White [non-Hispanic] 72%; Hispanic or Latino 11%; African American or Black 11%; Asian, Native Hawaiian or Other Pacific Islander 6%; American Indian/Alaska Native 1%) were derived from US Census data. Strategies to promote diverse recruitment include translation of participant-facing documents across multiple languages, participant and healthcare provider educational material, and site-led community outreach campaigns. MCED testing is an emerging, potentially paradigm-changing strategy in cancer screening, and PATHFINDER 2 is designed to characterize the safety, performance, and clinical implementation of the MCED test as a screening tool in a broad and representative population. Citation Format: Karthik V. Giridhar, Michael J. Demeure, Raymond H. Kim, Justin A. Chen, Shirish Gadgeel, Dax Kurbegov, Margarita Lopatin, Roland Matthews, Marc Matrana, Charles McDonnell, Donald Richards, Benjamin Rybicki, Gretchen Stipec, Nima Nabavizadeh. PATHFINDER 2: A prospective study to evaluate safety and performance of a multi-cancer early detection test in a population setting [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4784.

Preterm Birth Risk and Maternal Nativity, Ethnicity, and Race

Immigrant birthing people have lower rates of preterm birth compared with their US-born counterparts. This advantage and associated racial and ethnic disparities across the gestational age spectrum have not been examined nationally. To examine associations of maternal nativity, ethnicity, and race with preterm birth. This cohort study used birth certificates from the National Vital Statistics System to analyze in-hospital liveborn singleton births in the US between January 1, 2009, and December 31, 2018. Data were analyzed from January to June 2023. Mutually exclusive nativity, ethnicity, and race subgroups were constructed using nativity (defined as US-born or non-US-born), ethnicity (defined as Hispanic or non-Hispanic), and race (defined as American Indian or Alaska Native, Asian, Black, Native Hawaiian or Other Pacific Islander, White, or other [individuals who selected other race or more than 1 race]). The primary outcome of interest was preterm birth. Modified Poisson and multinomial logistic regression models quantified relative risk (RR) of preterm birth overall (<37 weeks' gestation) and by gestational category (late preterm: 34-36 weeks' gestation; moderately preterm: 29-33 weeks' gestation; and extremely preterm: <29 weeks' gestation) for each maternal nativity, ethnicity, and race subgroup compared with the largest group, US-born non-Hispanic White (hereafter, White) birthing people. The RR of preterm birth overall and by category was also measured within each racial and ethnic group by nativity. Models were adjusted for maternal demographic and medical covariates, birth year, and birth state. A total of 34 468 901 singleton live births of birthing people were analyzed, with a mean (SD) age at delivery of 28 (6) years. All nativity, ethnicity, and race subgroups had an increased adjusted risk of preterm birth compared with US-born White birthing people except for non-US-born White (adjusted RR, 0.85; 95% CI, 0.84-0.86) and Hispanic (adjusted RR, 0.98; 95% CI, 0.97-0.98) birthing people. All racially and ethnically minoritized groups had increased adjusted risks of extremely preterm birth compared with US-born White birthing people. Non-US-born individuals had a decreased risk of preterm birth within each subgroup except non-Hispanic Native Hawaiian or Other Pacific Islander individuals, in which immigrants had significantly increased risk of overall (adjusted RR, 1.07; 95% CI, 1.01-1.14), moderately (adjusted RR, 1.10; 95% CI, 0.92-1.30), and late (adjusted RR, 1.11; 95% CI, 1.02-1.22) preterm birth than their US-born counterparts. Results of this cohort study suggest heterogeneity of preterm birth across maternal nativity, ethnicity, and race and gestational age categories. Understanding these patterns could aid the design of targeted preterm birth interventions and policies, especially for birthing people typically underrepresented in research.

Abstract 66: US Asian and Pacific Islander Adolescents With Obesity Have Triple the Risk of Prediabetes When Compared to Non Hispanic White Children

Introduction: Race and ethnicity and elevated body mass index (BMI) are risk factors for pre-diabetes (preDM) among adolescents. We recently observed high preDM prevalence among aggregated US Asian and Pacific Islander (API) children with obesity, but data pertaining to disaggregated API subgroups remain limited. Aim: To examine the risk of preDM among API subgroups compared to non-Hispanic White (NHW) adolescents with obesity. Methods: This retrospective study included 3233 API and 4150 NHW children age 13-17y with obesity and without DM who were identified at preventive health well-child visits in 2016-2019 and had hemoglobin A1c (HA1c) measured within 1 year of the visit. Visit data included self-reported diet/lifestyle behaviors and BMI measurement. PreDM (outcome) was defined by HA1c 5.7-6.4%. Obesity was categorized as Class 1-3 based on BMI percent of the 95th BMI percentile (obesity threshold). Four obesogenic behaviors were ascertained from clinic data: Fruit/vegetable consumption &lt;5 servings/day; juice/sugary beverage intake &gt;12 ounces/day; exercising &lt;60 minutes/day; and screen time 2+ hours/day. A neighborhood deprivation index (NDI) was calculated using area of residence and 2010 US Census data. Log binomial regression was used to examine the association of API ethnicity and preDM, reporting relative risk (RR) and 95% confidence intervals [CI]. Results: The cohort included 210 Chinese, 900 Filipino, 200 South Asian, 132 Southeast Asian, 283 Native Hawaiian/Pacific Islander (NHPI), 1508 other/unspecified API ethnicity, and 4150 NHW children. Overall, 22.4% of API vs 9.4% NHW (p&lt;0.001) children had preDM. PreDM prevalence ranged from 19.1% for Chinese, 21.7% for Filipino, 22.5% for South Asian, 24.2% for Southeast Asian, to 26.5% for NHPI subgroups. After adjusting for age, sex, NDI, obesity class, and obesogenic health behaviors, risk of preDM was about 3-fold higher (RR 2.9 [2.6-3.4] for API compared to NHW adolescents, ranging from RR 2.5 [1.8-3.6] for Chinese, RR 2.8 [2.3-3.4] for Filipino, RR 3.1 [2.2- 4.4] for South Asian, RR 3.2 [2.1-4.9] for Southeast Asian, RR 3.3 [2.5-4.4] for NHPI, and RR 3.0 [2.5-3.5] for other/unspecified API children. Obesity severity (RR 1.4 [1.2-1.6] for Class 2 and RR 2.1 [1.7-2.6] for Class 3 compared to Class 1 obesity) was also associated with preDM risk. Conclusion: PreDM risk was about 3-fold higher for API compared to NHW children with obesity even after adjusting for sociodemographic, lifestyle, and BMI differences. The risk of preDM ranged from 2.5-fold to 3.3-fold higher for the major API subgroups, especially Southeast Asian and Filipino groups compared to NHW children. These findings highlight the importance of preDM screening among API children and demonstrate heterogeneity of risk among API subgroups. Future efforts should focus on effective screening and monitoring of at-risk populations to prevent progression to Type 2 DM.

Abstract P301: Nativity Explains Disparities in Provider Experience Scores Among Asian and Pacific Islander Patients With and Without Cardiovascular Disease

Introduction: Research has shown that Asian patients rate their patient-provider experience lower than Non-Hispanic White (NHW) patients. Few studies have examined whether experience scores differ by cardiovascular disease presence and disaggregated Asian race subgroups. Hypotheses: 1) NHW patients will have the highest healthcare experience scores, followed by multiracial Asian and Pacific Islander (API) patients, and then single race API patients; 2) patients with CVD will have lower scores than patients without CVD; and 3) longer duration in the U.S. will be associated with higher scores. Methods: We examined 5,234 participants, aged 40+ surveyed in two health systems in Hawai'i and California. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey quantified patient experience (range: 5-20). We dichotomized CAHPS to compare patients who scored low (&lt; 18) to high (18+). For immigrants, length of residence determined nativity. Multivariable logistic regression compared the association of race and low CAHPS, adjusting for age, sex, ethnic affiliation strength, education, nativity, and CVD diagnosis. Results: There were no significant differences in CAHPS score by CVD (Table). Chinese and Filipino patients had significantly higher odds of low CAHPS than NHW patients with adjustment for age and sex. These differences were fully attenuated when adjusting for nativity. Compared to U.S.-born people, immigrants who have lived in the U.S. between 0-19 years were more likely to have low CAHPS (OR = 2.13, 95% CI = 1.47, 3.10). Even immigrants who have lived in the U.S. for 20+ years had increased odds of low CAHPS (OR = 1.45, 95% CI = 1.16, 1.81). Conclusion: Although most people have positive provider experiences, differences remain by race. Nativity and duration in the U.S. explained racial variations in CAHPS among API individuals in our study. Research should continue disaggregating racial data by nativity status to improve the quality of care and health outcomes for immigrant populations.

Abstract P303: Investigating the Relationship Between Cardiovascular Diseases and Major Depressive Disorder Among Asians and Pacific Islanders

Background: Poorer mental health is associated with greater cardiovascular disease (CVD) morbidity, recovery, and mortality. Experiencing CVD is also associated with poorer mental health after a CVD event. What has been less examined, is how these associations differ among disaggregated Asian and Pacific Islander (API) groups who have a lower burden of both CVD and poor mental health relative to other racial groups. Objective: To examine the association between CVD diagnosis and experiencing major depressive disorder (MDD) among API people and how it differs between racial groups. Methods: We used survey data (n=5,229) from a study of API patients in Hawai’i and California with a linked electronic health record (EHR) data. Race, sex, body mass index (BMI) and CHD, Stroke, and PVD diagnosis were obtained from EHR while MI and CAD diagnoses were from the survey. Data on health behaviors and social determinants were obtained from the survey. Multivariate logistic regression models were used to determine the association between CVD and MDD. Results: Overall prevalence of MDD was 9.2%. Non-Hispanic White people (6.1%) had the lowest prevalence while “Pacific Islander and White” people had the highest prevalence (12.8%). In the fully adjusted models (Table), people who had a stroke (OR = 1.34, p &lt; .001), CHD (OR = 1.32, p = .01), CAD (OR = 1.35, p = .016) or PVD (OR = 1.49, p &lt; .001) had increased odds of MDD. There was a significant interaction between CAD and increased MDD that differed for Filipino, Asian Indian, “Pacific Islander and Asian”, “Asian and White”, and “Pacific Islander and White” groups compared to Non-Hispanic White people. Conclusion: Diagnosis of certain CVDs could increase the risk of experiencing MDD with potential race group differences for CAD. Further efforts should be made to protect the mental health of patients that have experienced a diagnosis of CVD as MDD can further harm their health outcomes. Moreover, research and treatment should consider potential racial differences in the experience of depression and CVD.

EHR Data and Inclusion of Multiracial Asian American, Native Hawaiian, and Pacific Islander People—Opportunities for Advancing Data-Centered Equity in Health Research

EHR Data and Inclusion of Multiracial Asian American, Native Hawaiian, and Pacific Islander People—Opportunities for Advancing Data-Centered Equity in Health Research

Incidence trends for common subtypes of T-cell lymphoma in Taiwan and the United States from 2008-2020.

The incidence of T-cell lymphoma (TCL) has been continually increasing in Taiwan and the United States (US) in recent years. This epidemiological study using population-based registry data aimed to determine the incidence patterns of common subtypes of TCL in Taiwan from 2008-2020 and compare them with those in the US and the Asian/Pacific Islander (API) population. Subtypes included angioimmunoblastic T-cell lymphoma (AITL); extranodal NK/T-cell lymphoma, nasal or other type (ENKTL); peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS); and anaplastic large cell lymphoma (ALCL). The total number of patients newly diagnosed with TCL during 2008-2020 was 4477, 3171, and 48,889 in Taiwan, API, and the US, respectively. Except the incidence rate of AITL in Taiwan, the incidence rates of these common TCL subtypes showed downward trends in all studied populations. There was also a significant increase in the relative frequency of AITL among TCL in Taiwan, with an annual percent change of 4.44 (p < 0.001), from 8.44% in 2002 to 20.63% in 2020. The rapid development of diagnostics may be the main factor contributing to this rise in incidence.

Heterogenous Association Between Mortality and Environmental Factors

The global environment has changed rapidly since the Industrial Revolution. Human emissions of heat-trapping greenhouse gases have warmed our earth, leading to more climate extremes. Human activities have also caused air pollution and, thus, worse air quality. Warmer climates and polluted air pose severe risks to human health. This paper focuses on temperature and air pollution as the primary environmental factors and studies their relationship with mortality across different ethnicity and age groups in the U.S. from 2001 to 2021. The main research methods employed in this paper are correlation analysis and least-square regressions. This paper finds that, on average, environmental factors are moderately and positively related to total deaths at a statistically significant level. Such a positive relationship still holds when I further investigate how the environment is associated with mortality by each individual cause. Moreover, heterogeneity in the relationship is identified among different races. In particular, temperature seems to have a larger impact on the Native Hawaiian/Pacific Islander and Black populations. At the same time, air pollution is observed to have a very strong association with the mortality of the Asian population, Pacific Islanders, and Hawaiian Natives. Finally, age disparities are not that significant. One finding worth pointing out is that children and teenagers (Age 1-14) appear to be more susceptible to air pollution than other age groups.

What's not in the grant: An exploration of project directors’ experiences at two‐year Asian American and Native American Pacific Islander serving institutions in the Midwest

AbstractThis article explores the experiences of project directors at two‐year Asian American and Native American Pacific Islander serving institutions in the Midwest. Specifically, we examined how project directors faced racialized campus environments, navigated support structures (or the lack thereof), and continually combatted misperceptions about the Asian American and Pacific Islander (AA/PI) communities and the Midwest. We discussed the isolation, myths, lack of institutional support, and campus climate for project directors and AA/PI communities. We end with recommendations.

Asian American and Pacific Islander Architectural Histories: Mapping the Field and Its Futures

Asian American and Pacific Islander Architectural Histories: Mapping the Field and Its Futures

Sociodemographic and precipitating circumstances associated with suicide among Asian Americans and Pacific Islanders: A survival analysis.

Sociodemographic and precipitating circumstances associated with suicide among Asian Americans and Pacific Islanders: A survival analysis.

Postoperative Complications After Sling Operations for Incontinence: Is Race a Factor?

Racial and ethnic disparities exist in urogynecologic surgery; however, literature identifying specific disparities after sling operations for stress incontinence are limited. The objective of this study was to evaluate racial and ethnic disparities in surgical complications within 30 days of midurethral sling operations. This retrospective cohort study identified women who underwent an isolated midurethral sling operation between 2014 and 2021 using the American College of Surgeons National Surgical Quality Improvement Program database. Women were stratified by racial and ethnic category to assess the primary outcome, 30-day surgical complications, and the secondary outcome, comparison of urinary tract infections (UTIs). There were 20,066 patients included. Mean age and body mass index were 53.9 years and 30.8, respectively. More Black or African American women had diabetes and hypertension, and more American Indian or Alaska Native women used tobacco. The only difference in 30-day complications was stroke/cerebrovascular accident, which occurred in only 1 Asian, Native Hawaiian or other Pacific Islander patient (0.1%, P < 0.0001). The most frequent complication was UTI (3.3%). Black or African American women were significantly less likely to have a diagnosis of UTI than non-Hispanic White (P = 0.04), Hispanic White (P = 0.03), and American Indian or Alaska Native women (P = 0.04). Surgical complications within 30 days of sling operations are rare. No clinically significant racial and ethnic differences in serious complications were observed. Urinary tract infection diagnoses were lower among Black or African American women than in non-Hispanic White, Hispanic White, and American Indian or Alaska Native women despite a greater comorbidity burden. No known biologic reason exists to explain lower UTI rates in this population; therefore, this finding may represent a disparity in diagnosis and treatment.

A Review of Factors Contributing to Asian Americans' Underutilization of Mental Health Services

Asian American and Pacific Islander (AAPI) people are three times less likely than white Americans to seek any type of mental health care services or resources. Understanding this phenomenon requires a nuanced approach due to the cultural differences and heterogeneity within Asian American (AA) communities. The purpose of this review is to explore the multitude of factors that contribute to the underutilization of mental health services among AAs. I will synthesize peer-reviewed articles that cover factors contributing to AAs’ attitudes and behaviors related to mental health and mental health services. Primary mechanisms include stigma and shame, knowledge and beliefs about mental health treatment, and access to care. Additionally, implications for understanding and treating AA communities will be discussed.

Vietnamese American Perspectives on Engagement in an Aging-Focused Research Registry

Introduction: We elicited Vietnamese Americans’ perspectives on culturally appropriate recruitment into a new research registry: Collaborative Approach for Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) Research and Education (CARE). Methods: Three focus groups were conducted with 21 Vietnamese Americans. Topics included knowledge about and experiences with research, outreach and recruitment methods for research participation and registry enrollment, and views about research incentives. Focus group transcripts were analyzed thematically. Results: Mean age of participants was 41 years (range 18–73), 57% were male, 86% were non-US born, and 81% had never participated in a research study. Themes that emerged included (1) motivations to participate in research to gain knowledge: for oneself, for family’s benefit, and for the Vietnamese American community as a whole; (2) necessity of trustworthy and credible individuals/spokespersons to promote the research initiative; (3) recruitment strategies that are age-specific and culturally appropriate, and (4) importance of monetary incentives. Conclusion: Findings from this study will be used to guide recruitment into and engagement with CARE among Vietnamese Americans but are also relevant for other registries aiming to diversify their participants.

Different as deficient: Challenging the language of difference in constructions of Marshallese and other minoritized students

This paper presents a discourse analysis of the role the label “different” plays in mitigating or constructing deficit discourses of Asian-Pacific Islander students in a school in the U.S. Some scholars argue that discourses of linguistic difference play a positive role in countering deficit ideologies (e.g., Paris & Ball 2009). Others disagree, claiming that discourses of difference index deficiency (e.g., Gorski, 2016). To address this debate, I analyze a discussion with a U.S. educator and the language we used to talk about her first- and second-generation Marshallese immigrant students. Both of us were trying to speak positively about both the students and Marshallese culture. Nonetheless, “different” inadvertently functioned as an index of deficiency and had the effect of racializing Marshallese students. This analysis illuminates some of the negative impacts a focus on “difference” can have and challenges academics to reconsider the role “different” plays in their research and advocacy.

Psychological Distress and Behavioral Vigilance in Response to Minority Stress and Threat among Members of the Asian American and Pacific Islander Community during the COVID-19 Pandemic.

Stigmatization, hostility, and violence towards the Asian American and Pacific Islander (AAPI) community have increased sharply during the COVID-19 pandemic. It is important to conduct research to promote understanding of the effects of such stigmatization on the AAPI community. Accordingly, the present study used a combined minority stress and integrated threat framework to examine whether factors related to AAPI identity would moderate the relationship between stigmatization/threat associated with AAPI identity and increased psychological distress and behavioral vigilance. AAPI individuals were recruited online from both Turk Prime and Reddit and completed measures of perceived stigmatization; integrated threat; depression, anxiety, and stress; and behavioral vigilance. Perceptions of stigmatization and threat predicted relevant outcomes both as individual predictors and in multivariate analyses. However, factors relating to the strength of AAPI identification did not moderate the effects of stigmatization and threat on psychological distress and behavioral vigilance, which is a result that failed to support this aspect of the broader conceptual model on which this project was based. Instead, these proposed moderators were themselves predicted by stigmatization and threat variables. The implications of these findings for effective interventions to alleviate the negative consequences of anti-Asian stigmatization are discussed.

Critical Issues Facing Asian Americans and Pacific Islanders in Organizations and Society

The discussion of Asian Americans and Pacific Islanders (AAPIs) in the context of the West is uniquely complex. AAPIs are often held up as “model minorities,” resulting in exclusion from many equity conversations. The lack of attention focusing on the experiences of AAPI communities in organizations and society suggests a need for us to remedy this. In this special issue, we curated a collection of eight papers that tackle a broad range of issues that advance conversations of AAPI communities and diasporas. We contend that it may be particularly beneficial to take a critical perspective (using Asian Critical Theory or AsianCrit) to bring to light and challenge systemic issues faced by AAPI communities in Western workplaces and societies. We also call for a post-model minority narrative, which has the potential to mitigate the adverse impacts that the notion of a model minority has on both intragroup and intergroup relations and well-being.

Clinical Trial Racial and Ethnic Disparities in Minimally Invasive Gynecologic Surgery

Study ObjectiveTo study racial and ethnicity disparities in randomized clinical trials (RCT) in Minimally Invasive Gynecologic Surgery (MIGS). DesignCross sectional study. SettingOnline review of all published MIGS RCTs in high-impact journals from 2012 to 2023. PatientsJournals included all Q1 Obstetrics & Gynecology journals, as well as The New England Journal of Medicine, The Lancet, The British Medical Journal, and The Journal of the American Medical Association. The National Institutes of Health's PubMed and the ClinicalTrials.gov websites were queried using the following search terms from the American Board of Obstetrics and Gynecology's certifying examination bulletin 2022 to obtain relevant trials: adenomyosis, adnexal surgery, abnormal uterine bleeding, cystectomy, endometriosis, fibroids, gynecology, hysterectomy, hysteroscopy, laparoscopy, leiomyoma, minimally invasive gynecology, myomectomy, ovarian cyst, robotic surgery InterventionsThe United States (US) Census Bureau data was used to estimate the expected number of participants. We calculated the enrollment ratio (ER) of actual to expected participants for US trials with race and ethnicity data available. Measurements and Main ResultsA total of 352 RCTs were identified. Of these, race and/or ethnicity data were available in 65 studies (18.5%). We analyzed the 46 studies that originated in the US, with a total of 4,645 participants. Of these RCTs only 8 (17.4%) reported ethnicity in addition to race. When comparing published RCT data to expected proportions of participants, White participants were overrepresented [70.8% versus 59.6%, ER 1.66, 95% confidence interval (CI) 1.52-1.81], as well as Black or African American participants (15.4% versus 13.7%, ER 1.15, 95% CI 1.03-1.29). Hispanic (6.7% versus 19.0%, ER 0.31, 95% CI 0.27-0.35), Asian (1.7% versus 6.1%, ER 0.26, 95% CI 0.20-0.34), Native Hawaiian or Other Pacific Islander (0.1% versus 0.3%, ER 0.21, 95% CI 0.06-0.74), and Indian or Alaska Native participants (0.2% versus 1.3%, ER 0.16, 95% CI 0.08-0.32) were underrepresented. When comparing race/ethnicity proportions to the 20 states where the RCTs were conducted, Black or African American participants were underrepresented. ConclusionIn MIGS RCTs conducted in the US, White and Black or African American participants are overrepresented compared to other races, and ethnicity is characterized in fewer than one fifth of trials. Efforts should be made to improve racial and ethnic recruitment equity as well as reporting in future MIGS RCTs.

Racial disparities in genitourinary cancer mortality trends in the United States, 2000-2020: A CDC database study.

28 Background: Prostate, bladder, and kidney cancers account for substantial burden of cancer incidence and mortality in the United States. In 2020, an estimated 168,000 new cases and 32,000 deaths were attributed to these cancers. Studies examining racial disparities of mortality trends are needed. Methods: We utilized the CDC WONDER database to obtain mortality data for kidney, bladder, and prostate cancers between 2000-2020. Age-adjusted mortality rates per 100,000 persons were calculated and standardized to the Year 2000 US standard population. Rates were stratified by race, including White, Black, Asian/Pacific Islander (API), and American Indian/Alaska Native (AIAN). The National Cancer Institute Joinpoint Regression Program was utilized to calculate average annual percent changes (AAPCs). AAPCs were considered significant if the 95% confidence interval (CI) excluded zero. Results: Over the study period, 318,919 kidney cancer deaths, 150,613 bladder cancer deaths, and 516,508 prostate cancer deaths were identified. Between 2000-2020, amongst all races, mortality from prostate cancer (-1.8%; CI -2.0, -1.6), bladder cancer (-0.3%; CI -0.5, -0.2), and kidney cancer (-1.1%; CI -1.2, -0.9) all significantly declined. Considering racial disparities, prostate cancer mortality fell considerably in all race groups, most significantly among Black (-2.8%, CI -3.2%, -2.4%) and AIAN (-2.4%, CI -2.9%, -1.8%) populations, outpacing reductions in API (-1.7%, CI -2.6%, -0.8%) and White (-1.6%, CI -1.9%, -1.4%) populations. In bladder cancer, the decline in mortality was statistically significant for Black (AAPC: -0.8%, CI -1.1%, -0.6%) and for White, (-0.4%, CI -0.6%, -0.1%), but not for API individuals (-0.3%, CI -0.9%, 0.3%). For kidney cancer, mortality dropped substantially across all examined races, with the steepest decline seen in Black (-1.4%, CI -1.7%, -1.2%) and AIAN (-1.7%, CI -2.5%, -1.0%) compared to White (-1.0%, CI -1.2%, -0.9%) and API (-1.4%, CI -4.2%, 1.6%, non-significant) population. Conclusions: This study represents the most comprehensive population database analysis assessing GU cancer mortality trends. While an overall decline in GU cancer mortality was observed, which was comparatively greater for Black Americans over the past two decades, significant racial disparities continue to persist. Focused and targeted efforts are essential to address these disparities. [Table: see text]

Assessing Physicians' Recommendations for Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Testing Among Minority Populations in Greater Philadelphia and New York City.

Deaths from liver cancer are on the rise and disproportionately affect minority racial/ethnic groups. In this study, we examined associations between physicians' recommendations for hepatitis B virus (HBV) and hepatitis C virus (HCV) screening and sociodemographic and lifestyle factors among minority populations in the areas of Greater Philadelphia and New York City. Using Poisson regression with robust variance estimation, we evaluated potential associations for 576 Hispanic American (HA), African American (AA), and Asian Pacific American (APA) adults, using blood tests as an outcome measure, with adjustment for sociodemographic factors We found that APAs (34.2%) were most likely to have a physician recommend HBV and HCV screening tests (34.2% and 27.1%, respectively), while HAs were least likely to receive an HBV recommendation (15.0%) and AAs were least likely to receive an HCV recommendation (15.3%). HAs were significantly likely to have never received a blood test for either HBV or HCV (RR = 1.25, 95% CI: 1.05, 1.49). APAs were significantly more likely to receive a screening recommendation for HBV (RR = 1.10, 95%CI: 1.01, 1.20) and to have a blood test (RR = 1.57, 95% CI: 1.06, 2.33). Our findings show that, among HAs, AAs, and APAs, physician recommendations are strongly associated with patients undergoing blood tests for HBV and HCV and that minority populations should increasingly be recommended to screen for HBV and HCV, especially given their elevated risk.