Asian Subgroups Research Articles

Approaches to Filipino American Community Engagement in Prevention Research: A Scoping Review.

The topic of this scoping review is the use of targeted engagement methods to engage Filipino Americans (FAs) in prevention research studies. FAs are the third largest Asian subgroup in the United States. Given the historical relationship between the Philippines and United States, FAs are often under-represented in research and are hard to reach due to factors such as cultural mistrust, linguistic mismatch, and unfamiliarity with research. This scoping review synthesized findings across 11 studies which met the criteria for inclusion. Studies were included if they demonstrated engagement methods with FA communities, applied participatory action research methods, cultural adaptations, and/or stakeholder consultation. Studies were excluded if engagement was not identified as a focus, did not involve stakeholders in recruitment, were simply published as extensions of earlier studies, conducted outside of the United States, or not in English. Studies reviewed represent a range of research designs, including randomized controlled trials, intervention adapted research, needs assessments, semi-structured interviews, qualitative studies, program evaluation research, and community-based participatory research. Findings identified a range of methods and strategies for engaging FA in research. Integration of cultural values, recruiting from cultural sites and use of bilingual staff and moderators were most often utilized. In addition, this review highlighted barriers to engagement and strategies to address them. Using culturally congruent engagement strategies will aid researchers in building trust and encourage participation.

“Asian” Is a Problematic Category in Research and Practice: Insights From the Bamboo Ceiling

This article spotlights a widespread problem in research and practice: Asians are commonly categorized as a monolithic group in the United States. Regarding research, my 24-year archival analysis of Psychological Science shows that most U.S. studies did not specify which Asian subgroup(s) were examined. Regarding practice, my analysis of the diversity, equity, and inclusion (DEI) webpages and latest diversity reports of S&P 100 companies finds that none of them differentiated between Asian subgroups. Such use of the generic category “Asian” is problematic because it masks important differences among Asian subgroups: (a) Of all ethnic groups in the United States, socioeconomic inequality among Asian subgroups is the highest and fastest growing; (b) U.S. studies show that East Asians (e.g., ethnic Chinese)—but not South Asians (e.g., ethnic Indians)—experience a “bamboo ceiling” in consequential contexts, including leadership attainment, academic performance in law and business schools, and starting salaries. Thus, lumping Asians together can obscure the challenges faced by certain Asian subgroups and jeopardize the attention and resources they need. More broadly, this article demonstrates the importance of differentiating between ethnic subgroups in research (e.g., theorization, surveys, and data analysis) and practice (e.g., diversity reports) to foster DEI.

Asian American Representation in Medicine by Career Stage and Residency Specialty.

Asian American individuals are not underrepresented in medicine; however, aggregation in prior workforce analyses may mask underlying disparities. To assess representation by Asian race and disaggregated subgroups in the US allopathic medical school workforce. This cross-sectional study used Association of American Medical Colleges (AAMC) special reports, generated using the AAMC Applicant-Matriculant Data File, Student Records System, Graduate Medical Education Track Survey, and faculty roster. Participants included medical school applicants, matriculants, graduates, residents, and faculty enrolled or employed at US allopathic medical schools between 2013 and 2021. Data were analyzed between March and May 2024. Asian race or ethnic subgroup as per AAMC and US Census Bureau Office of Management and Budget criteria, including Bangladeshi American, Cambodian American, Chinese American, Filipino American, Indian American, Indonesian American, Japanese American, Korean American, Pakistani American, Taiwanese American, and Vietnamese American. Representation quotients (RQ) were used to indicate representation that was equivalent (RQ of 1), higher (RQ greater than 1), or lower (RQ less than 1) than expected representation based on US population estimates. One-way analysis of variance and linear regression models assessed mean RQ differences by career stage and over time, with Bonferroni correction for multiple comparisons. In this study, Asian American individuals accounted for 94 934 of 385 775 applicants (23%), 39 849 of 158 468 matriculants (24%), 37 579 of 152 453 graduates (24%), 229 899 of 1 035 512 residents (22%), and 297 413 of 1 351 187 faculty members (26%). The mean (SD) RQ was significantly greater among Asian American residents (3.44 [0.15]) and faculty (3.54 [0.03]) compared with Asian applicants (3.3 [0.04]), matriculants (3.37 [0.03]), or graduates (3.31 [0.06]). Upon disaggregation, RQ was significantly lower among residents and faculty in 10 of 12 subgroups. Although subgroups, such as Taiwanese American, Indian American, and Chinese American, had RQs greater than 1 (eg, Chinese American graduates: mean [SD], RQ, 3.90 [0.21]), the RQs were less than 1 for Laotian, Cambodian, and Filipino American subgroups (eg, Filipino American graduates: mean [SD], RQ, 0.93 [0.06]) at almost every career stage. No significant RQ changes were observed over time for Laotian American and Cambodian American trainees, with a resident RQ of 0 in 8 of 25 and 4 of 25 specialties, respectively. Faculty RQ increased in 9 of 12 subgroups, but Cambodian American, Filipino American, Indonesian American, Laotian American, and Vietnamese American faculty (eg, Vietnamese American faculty: mean [SD], RQ, 0.59 [0.08]) had RQs less than 1. In this cross-sectional study of Asian representation in US allopathic medical schools, Laotian American, Cambodian American, and Filipino American individuals were underrepresented at each stage of the physician workforce pathway. Efforts to promote diversity in medicine should account for these disparities to avoid perpetuating inequities.

Examining Whether Patient Portal and Video Visit Use Differs by Race and Ethnicity Among Older Adults in a US Integrated Health Care Delivery System: Cross-Sectional Electronic Health Record and Survey-Based Study.

Health care systems are increasingly encouraging patients to use patient portals and participate in video visits. However, there is limited information about how portal use differs among older adults. This study aimed to understand how patient portal and video visit use differed by age, race, and ethnicity among older adult patients with access to the same digital health resources. This cross-sectional study used electronic health record and survey data for adults aged 65 to 85 years who were members of a large Northern California health care delivery system throughout 2019 and 2020. The electronic health record cohort (N=471,152) included 320,686 White, 35,892 Black, 44,922 Latino, 20,786 Chinese, 28,732 Filipino, 8473 South Asian, 6716 Japanese, 2930 Vietnamese, and 2015 Korean adults. Racial and ethnic group and age group (65 to 75 years vs 76 to 85 years) differences in having a patient portal account by December 2020, the performance of 2 portal activities (sending ≥1 message to a clinician in 2019 or 2020 and viewing ≥1 laboratory test result in 2020), and having ≥1 video visit during 2020 were examined. Modified log-Poisson regression was used to examine prevalence ratios for portal and video visit use, comparing racial and ethnic groups to White adults and Asian ethnic groups to Chinese adults after adjusting for sex and age. Data from a 2020 member survey were used to compare internet use factors among 2867 White, 306 Black, 343 Latino, 225 Chinese, and 242 Filipino adults. Black, Latino, and Filipino adults were less likely to have a patient portal account than White adults, and Filipino adults were less likely to have a patient portal account than Chinese adults. Black, Latino, Filipino, Korean, Vietnamese, and South Asian adults were less likely to have sent messages and viewed test results than White adults, while Chinese and Japanese adults' use of these features was similar to that of White adults. Filipino, Vietnamese, and Korean adults were less likely to have performed the aforementioned activities than Chinese adults. Video visit use was lower among Black and Latino adults and higher among Chinese and South Asian adults compared with White adults (aged 76 to 85 years) and lower among Filipino, Korean, and Vietnamese adults compared to Chinese adults. Survey data suggested that underlying differences in internet use may partially explain the lower use of messaging by Black, Latino, and Filipino adults compared with White and Chinese adults. Patient portal and video visit use differed by race, ethnicity, and age group among older adult patients with access to the same patient portal. Internet use factors may contribute to these differences. Differences in patient portal and video visit use across Asian subgroups underscore the importance of disaggregating use data by Asian ethnicity.

Methionine synthetase A2756G and Cystathionine-β-synthase 844ins68 polymorphisms and coronary artery disease: a meta-analysis

Objective: Methionine synthetase (MS) A2756G and Cystathionine-β-synthase (CBS) 844ins68 gene polymorphisms were indicated to be associated with increased coronary artery disease (CAD) risk. Nevertheless, because the results of each experiment are different, there is no consensus till now. This meta-analysis aimed to clarify the relationship between MS gene A2756G and CBS gene 844ins68 polymorphisms and CAD.Methods: 11,555 participants from 24 individual studies, 2162 participants from 6 individual studies were included in the MS gene A2756G and CBS 844ins68 gene polymorphisms meta-analysis respectively. To determine whether MS gene A2756G or CBS gene 844ins68 polymorphism was associated with CAD risk, a random or fixed-effect genetic model was adopted using pooled odds ratios (ORs) and their corresponding 95% confidence intervals (CIs).Results:MS gene A2756G polymorphism was significantly associated with CAD under recessive (OR: 1.400, 95% CI: 1.119-1.751, P=0.003) and homozygous genetic models (OR: 1.360, 95% CI: 1.084-1.706, P=0.008). In the African subgroup, the association was significant under the allelic, recessive, dominant, heterozygous, homozygous and additive (P<0.05) genetic models. In the Asian subgroup, the association was significant under the allelic, recessive and homozygous genetic models (P<0.05). No significant association was found between CBS 844ins68 gene polymorphism and CAD under all of the genetic models (P>0.05).Conclusions:MS gene A2756G polymorphism was significantly associated with increased CAD risk, especially in the African and Asian population. The G allele carriers of MS gene A2756G polymorphism were more susceptible to be suffered from CAD disease than others.

Methodologies for the disaggregation of Asian racial and ethnic subgroups to determine trends in ovarian cancer

Methodologies for the disaggregation of Asian racial and ethnic subgroups to determine trends in ovarian cancer

Cardiovascular risk factors and disease mortality among asian american subgroups

Abstract Background Asian Americans are the fastest growing racial group in the United States. Although Asian subgroups have distinct cardiovascular (CV) risk profiles, they are often aggregated together for public health surveillance. Purpose We provide the first comprehensive national estimates of CV and CV risk factor mortality in Asian American subgroups to assess differences in CV risk. Methods We used CDC WONDER, which captures all death certificates in the US (2018-2020), as well as the American Community Survey for demographic data. Adults aged ≥18 years were included. Estimates of age-adjusted overall CV mortality, as well as heart disease, hypertension, and stroke-related mortality, were determined by ICD-10 codes. To compare the contribution of each cause of mortality among subgroups with different baseline all-cause mortality rates, proportional mortality rates were determined by race. Proportional mortality was defined as the mortality rate of each condition divided by the all-cause mortality for that race group. Differences in proportional mortality by race and ethnicity, compared with White American adults, were assessed with age-sex adjusted linear regression. Results The US population consisted of 12,950,565 Asian Americans (53.7% female). Among the Asian American subgroups, 25.4% were Asian Indian, 28.5% Chinese, 19.7% Filipino, 5.3% Japanese, 9.6% Korean, and 11.8% Vietnamese. A total of 160,282,147 adults were White. Age-adjusted baseline mortality rates are shown in the Table. Compared with White adults, Asian Indian (34.5% vs 29.3%; adjusted difference 5.2%, [95% CI: 1.8%, 8.6%], P=0.009) and Filipino (32.8% vs 29.3%; adjusted difference 3.5%, [95% CI: 0.1%, 6.9%], P=0.04) adults had significantly higher proportional mortality from all CV causes. Asian Indian (26.0% vs 22.6%; adjusted difference 3.2%, [95% CI: 0.3%, 6.2%], P=0.04) adults had higher proportional mortality from heart disease than White adults, while Korean (17.3% vs 22.6%; adjusted difference -5.2%, [95% CI: -8.1%, -2.2%], P=0.01) and Vietnamese (17.5% vs 22.6%; adjusted difference -5.1%, [95% CI: -8.0%, -2.1%], P=0.01) adults had lower proportional mortality. Every Asian American subgroup had higher proportional mortality from hypertension causes compared with White adults, except for Asian Indians (Figure). In addition, every Asian American subpopulation had higher proportional mortality from stroke compared with White adults (Figure). Conclusions CV risk factor and disease-related mortality varies substantially among Asian American subgroups. Public health efforts targeted to address CV health disparities among the diverse group of Asian Americans are needed.

Hawai‘i face database: a racially and ethnically diverse set of facial stimuli

ABSTRACT Within psychology, face perception processes have been widely studied, examining traits and social categories that a face can communicate. However, much of this research has predominately focused on White faces. We review existing face databases that include racially diverse stimuli and note the lack of representation of Asian subgroups (e.g. East, South, and Southeast Asian), Pacific Islanders, as well as both Multiracial and multiethnic faces (especially with multiple minoritized backgrounds). We provide a new racially diverse set of free, standardized images including 140 unique faces representing eight different groups that vary in ethnicity and race (Asian, East Asian, Southeast Asian, Pacific Islander/Native Hawaiian, Hispanic/Latinx, White, Multiracial, and Multiracial Asian), along with norming data. These images and data are available for access use in research: https://osf.io/fkn7y

Ethnic disparities in perceived racism, patient-provider communication and healthcare utilization: Asian Americans

ABSTRACT Background Race is a consequential sociocultural cue in healthcare contexts. Racism is associated with health disparities by influencing patient-provider communication and utilization of healthcare services. Objective This study aimed to investigate how Asian American subgroups differ in their perception of everyday racism, internalized racism, and perceived racism in healthcare settings and whether these perceptions predict their interactions with their health care providers and their utilization of healthcare services. Methods An online survey study was conducted. ANOVA tests were employed to compare the differences in perceptions of everyday racism, internalized racism, and perceived racism in the healthcare system among Filipino (N = 310), Japanese (N = 242), Chinese (N = 287), Asian Indian (N = 304), Korean (N = 199) and Vietnamese (N = 151) participants. Multiple regression analyses assessed whether perceptions of everyday racism, internalized racism, and perceived racism in the healthcare system predicted healthcare service utilization and patient-provider communication among the Asian subgroups sampled. Results There were significant group differences in perceived everyday racism (F = 8.56, p < .001), internalized racism (F = 3.46, p < .01), perceived racism in healthcare (F = 4.57, p < .001). Perceptions of racism and socioeconomic variables were found to predict patient-provider communication and utilization of healthcare services disparately across various Asian subgroups. For instance, the perception of everyday racism was a significant predictor of patient-provider communication for each of the subgroups, excluding the Vietnamese participants. Internalized racism was a significant predictor only for Filipino and Chinese participants. Surprisingly, perceived racism in healthcare was not a predictor for any of the subgroups. Conclusion Findings highlight the complex interplay of sociodemographic factors and perceived racism in shaping patient-provider communication and healthcare service utilization within the Asian American community. Implications are suggested for addressing the unique challenges faced by different Asian American subgroups and for promoting equitable healthcare access and fostering positive patient-provider relationships among the Asian American subgroups.

S1112 Trends in the Prevalence of Diagnosed Inflammatory Bowel Disease among Asian Subgroups in a Large Northern California Population

S1112 Trends in the Prevalence of Diagnosed Inflammatory Bowel Disease among Asian Subgroups in a Large Northern California Population

O3-4 First-line tislelizumab plus chemotherapy in gastric/gastroesophageal junction cancer: RATIONALE-305 Asian Subgroup

O3-4 First-line tislelizumab plus chemotherapy in gastric/gastroesophageal junction cancer: RATIONALE-305 Asian Subgroup

Association of Prepregnancy Cardiometabolic Factors With Gestational Diabetes Among Asian Populations in the United States

BackgroundAsian individuals are among the highest immigrant group to the United States and at particularly high risk of gestational diabetes, which is associated with long-term maternal cardiovascular disease. Limited data are available on the association of prepregnancy cardiometabolic risk factors with gestational diabetes among Asian American subjects. ObjectivesThis study sought to determine the association of prepregnancy hypertension and body mass index (BMI) among Asian ancestry subgroups and by maternal nativity. MethodsUsing data from the National Vital Statistics System from 2016 to 2019, the prevalence of gestational diabetes, stratified according to prepregnancy hypertension and obesity, was examined according to maternal race. Predicted probability of gestational diabetes with continuous BMI was calculated across Asian ancestry subgroups and by maternal nativity. ResultsAmong 13.3 million pregnancies, gestational diabetes occurred in 6.5%. Asian subjects had the highest prevalence (12.3%). Among those with prepregnancy hypertension, Asian subjects had the highest prevalence (29.3%). Across the range of BMI (18-42 kg/m2), Asian subjects had the highest predicted probability. There was substantial heterogeneity across Asian ancestry subgroups between the association of BMI with gestational diabetes, with highest probability among Japanese and Korean American subjects at BMI >23 kg/m2. Predicted probability of gestational diabetes was higher for mothers born outside the United States among all Asian subgroups, except for Japanese American subjects. ConclusionsAsian American individuals have the highest prevalence of gestational diabetes at any BMI and with hypertension. Substantial variation in risk is present across Asian subgroups. Findings suggest a need for more tailored screening and intervention for gestational diabetes among Asian American subjects, with a specific focus on risk for individuals born outside the United States.

Abstract B050: Health and faith in the Korean community: Increasing breast and colorectal cancer education and screening in Los Angeles

Abstract Background: Koreatown in Los Angeles is home to over 115 churches within 3 miles. Korean churches are sanctuaries that provide support and nurture social connections, especially among Korean immigrants with limited English proficiency, who face challenges in accessing cancer care, including language barriers, lack of health insurance, and fears associated with cancer screening procedures and treatments. Koreans experience higher incidence and prevalence rates of breast and colorectal cancers compared to non-Hispanic White and other Asian subgroups, respectively. To address this, a Health and Faith Initiative was launched in 2018, utilizing evidence-based strategies recommended by Center for Disease Control and Prevention Community Guide and the use of a Cancer 101 curriculum developed by the Fred Hutchinson Cancer Center. METHODS: A three-stage Partnership Development Framework (networking, education, program and research development) was used to grow deep connections and sustainable cancer screening programs with church pastors and leaders, patient navigators, Federally Qualified Health Centers, State Breast and Cervical Early Detection Program providers, Diagnostic facilities, Hospitals and Community Outreach and Engagement staff. Bi- lingual church leaders was selected by pastors and elders at churches were trained as lay community navigators to conduct cancer education workshops using a Cancer 101 curriculum, as well as to support for church member to navigate across the cancer continuum. Church pastors and community health clinics determine outreach, engagement, and research priorities through active participation in Community Advisory Board and research studies. The initiative is sustained through coordination of 2 outreach staff and financial assistance from community benefit and research grants at Cedars Sinai Cancer Center. RESULTS: From June 2023 to May 2024, Community Outreach and Engagement (COE) have led the coordination of 6 breast cancer health education workshops and screening events with 165 people screened (128 screening mammograms, 37 diagnostic mammograms &amp; ultra sounds) in partnership with Koryo Health Foundation. Two patients were diagnosed with breast cancer and were referred to Cedars Sinai for treatment. For colorectal cancer, 8 health education workshops were conducted, and 122 Fit Kits were distributed with 72 kits returned, a 59% return rate. Cancer education workshops using American Cancer Society cancer screening guidelines for breast, colorectal, prostate, cervical, lung cancer has reached 810 people during 5 tabling events. Those who were not up to date were referred to our partnered health clinics for screening. CONCLUSION: Engaging Korean church leaders and training community navigators is an effective outreach strategy to build long-lasting partnership for successful implementation of cancer screening interventions but also support patients in needed follow up care that help immigrant populations to navigate across the cancer continuum. Citation Format: Dong Hee Kim, Min Jung Sung, Moon Ju Kim, Jeong Yup Lee, Reener Balingit, Zul Surani. Health and faith in the Korean community: Increasing breast and colorectal cancer education and screening in Los Angeles [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B050.

Abstract B045: Colorectal cancer screening education intervention for Chamoru and Filipinos in Guam and Hawai‘i: Recommendations for culturally and age relevant education

Abstract Background. Pacific Islanders and Filipinos have low rates of colorectal cancer (CRC) screening. Filipinos in the US territory of Guam and the state of Hawai‘i comprise one of the largest ethnic racial groups in these locations, and CHamoru (Chamorro) in Guam constitute a majority of the population. The CRC age-adjusted mortality rate in Guam (17.3) is higher than the overall US (14.2) with a high rate among CHamoru (23.2). In Guam 45.6% of persons aged 45 and above have met USPSTF screening standards while in Hawai‘i Filipinos have the lowest CRC screening rates (69.9%) among Asian and Pacific Islander ethnic subgroups. Interventions to increase CRC screening in these populations are limited. This study explores recommendations for culturally relevant components of a CRC screening education intervention for CHamoru and Filipinos in Guam and Hawai‘i aged 40 and above. Methods. Qualitative methods employed focus groups (FG) and key informant interviews (KII) to facilitate storytelling, creating a familiar and safe space for knowledge, cultural beliefs, and screening education recommendations. Respective community councils advised on the study. A common FG and KII semi-structure guide was implemented. Purposive and snowball sampling was utilized. FGs were age and gender specific, e.g., men in their 40s, women aged 50+, etc. Three levels of thematic coding were performed using Dedoose and included input from community councils. Coding teams comprised of 3 coders compared for corroboration and recoding continued until coders reached agreement. Results: Five FGs and 12 KIIs (N=37) were conducted with persons aged 40 and above. Participants were CHamoru (46%), Filipino (59%), female (59%), and male (41%). In Guam CRC prevention preferences varied by age and gender; those in their 40s preferred culturally tailored video and less preference for an online module compared to groups age 50, and men identified the need for more awareness and outreach. Filipinos in Hawai‘i were not aware of CRC and prevention prioritizing economic obligations (job) over seeking health services. The preferred characteristics of culturally tailored CRC prevention education in Guam and Hawai‘i were trusted knowledge sources to deliver information, storytelling as a format, and involving families. Participants in Guam also preferred online sources while Hawai‘i preferred all types of media in Filipino languages. Conclusion. CHamoru and Filipinos in Guam and Hawai‘i are receptive to family as a source of information and support for CRC prevention, and hearing personal stories motivates CRC screening. Findings give insight toward age-and culturally-tailored CRC screening education with site specific preferences. Findings will be used to develop family-focused interventions for CHamoru and Filipinos to improve CRC screening. Citation Format: Tressa P. Diaz, Angela Sy, Jena Funakoshi, Elizabeth Elmore, Santino Camacho, Alisa Peralta, Marc Rollon. Colorectal cancer screening education intervention for Chamoru and Filipinos in Guam and Hawai‘i: Recommendations for culturally and age relevant education [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B045.

Abstract B178: Examining ovarian cancer survival by Asian American ethnic subgroup: An analysis of California Cancer Registry data

Abstract Background: Ovarian cancer is the leading cause of death among gynecologic malignancies. However, outcomes are not the same for all women with studies showing Asian Americans having the highest survival across all major racial groups. Since the Asian American population is heterogeneous, we examined ovarian cancer survival by Asian ethnic subgroup using data from the California Cancer Registry. Most ovarian cancer survival studies evaluate Asian Americans as a single aggregated group, which may mask important ethnic-specific disparities. Methods: A total of 31,230 ovarian cancers diagnosed among non-Hispanic Whites and Asian/Pacific Islanders between 1996 and 2020 were included in the analysis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to evaluate the risk of dying from ovarian cancer comparing the Asian ethnic subgroups to non-Hispanic Whites using Cox proportional hazards models. The survival analyses also considered demographic, tumor, socioeconomic, and treatment characteristics. Results: For most Asian ethnic subgroups, risk of dying from ovarian cancer was comparable to non-Hispanic Whites with the only exception being Other Asians who showed a statistically significant 15% decreased risk of ovarian cancer death (HR=0.85, 95% CI 0.73-0.97, p-value=0.02). Another notable finding was the increased risk of death observed among Pacific Islander ovarian cancer patients when compared to non-Hispanic White patients (HR=1.27, 95% CI 0.99-1.62, p-value=0.06). Conclusion: Although most studies show Asian Americans having the highest ovarian cancer survival, our analyses indicate that only Other Asians have better survival and Pacific Islanders may have poorer survival relative to non-Hispanic Whites, highlighting the importance of disaggregation in future studies. These ethnic-specific disparities that were observed even after accounting for relevant survival-related characteristics should be further explored as it may inform important biological and behavioral factors associated with survival, which are not captured in cancer registry data. Citation Format: Alice W. Lee, Jenny Chang, Sannia Siddiqui, Argyrios Ziogas, Robert E. Bristow. Examining ovarian cancer survival by Asian American ethnic subgroup: An analysis of California Cancer Registry data [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B178.

Abstract B177: Association between ethnicity and ovarian cancer tumor characteristics in Asian Americans in California

Abstract Background: Ovarian cancer is often associated with poor survival given that most patients are diagnosed at advanced stages when treatment is less effective. The disease is also very heterogeneous, consisting of various histologic subtypes that each have distinct epidemiologic and pathologic profiles. Given that some studies have noted ethnic-specific disparities in ovarian cancer survival when the Asian American population is disaggregated and certain tumor characteristics are associated with more favorable outcomes, we examined the relationship between Asian ethnic subgroup and ovarian cancer disease presentation. Methods: We included a total of 31,230 non-Hispanic White and Asian/Pacific Islander ovarian cancer cases diagnosed between 1996 and 2020 from the California Cancer Registry. Multivariable logistic regression with odds ratios (ORs) and 95% confidence intervals (CIs) was used to examine the likelihood of being diagnosed with tumors of a certain stage, grade, and histologic subtype, for each Asian ethnic subgroup compared to non-Hispanic Whites. Demographic and socioeconomic factors were considered in the analyses. Results: Most, but not all, Asian ethnic subgroups were less likely to be diagnosed with advanced stage ovarian cancer and more likely to be diagnosed with clear cell ovarian cancer compared to non-Hispanic Whites. For South East Asians, the odds of having advanced stage tumors were 43% lower than non-Hispanic Whites (OR=0.57, 95% CI 0.41-0.79) and the odds of having clear cell tumors were almost 200% higher than non-Hispanic Whites (OR=2.97, 95% CI 1.92-4.61); only South Asians did not show lower odds of an advanced stage tumor diagnosis (OR=1.06, 95% CI 0.86-1.29) and higher odds of a clear cell tumor diagnosis (OR=0.93, 95% CI 0.63-1.37). Conclusion: There are clear differences in ovarian cancer disease presentation when each Asian ethnic subgroup is examined separately with South Asians constituting the only subgroup who did not show a lower likelihood of an advanced stage diagnosis and a higher likelihood of a clear cell diagnosis when compared to non-Hispanic Whites. Given that tumor stage and histologic subtype are considered important prognostic factors for ovarian cancer, identifying the underlying factors that may contribute to being diagnosed with certain tumor characteristics could provide clues to help us improve the survival of this highly fatal malignancy. Citation Format: Alice W. Lee, Jenny Chang, Sannia Siddiqui, Argyrios Ziogas, Robert E. Bristow. Association between ethnicity and ovarian cancer tumor characteristics in Asian Americans in California [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B177.

Abstract A129: So much of everything is rooted and caring for the family:” Community-Informed Colorectal Cancer Screening Education Recommendations for Filipinos in Hawaiʻi

Abstract Background. Colorectal cancer (CRC) incidence in Hawai‘i is higher than the U.S. with the highest age-adjusted rates among Filipinos. Among Asian and Pacific Islander ethnic subgroups in Hawaiʻi, Filipinos have the lowest CRC screening rates (69.9) compared to Japanese (82.0), and Native Hawaiians (73.3). Majority of CRC diagnoses can be prevented by CRC screening. This qualitative pilot study examined descriptive cognitive and cultural beliefs associated with CRC and screening and recommendations for culturally relevant prevention to reach Filipinos in Hawaiʻi. Methods. Key informant interviews were conducted in English with Ilokano translation when needed. Questions covered participants' knowledge about CRC and screening and their preferences in receiving CRC prevention education. Interviews lasted 15-30 minutes and were transcribed verbatim. Using Dedoose, two coders used inductive thematic coding. Codes were compared for corroboration, a referee was included when needed, and recoding continued until coders reached agreement. Results. Eleven females and three males (N=12) aged 50+ who identified as Filipino were interviewed. A total of 293 codes were created under 12 primary themes, e.g., “CRC attitudes and beliefs,” “family,” “culture-deterrents.” Common themes across interviewees were : 1) Health is not a priority 2) Family as motivation 3) No/limited knowledge of colorectal cancer 4) Education preferred through personal experiences and familiar relationships. Knowledge of CRC was low (N=9/12). Healthcare is often deprioritized due to cultural beliefs (N=11/12), busy schedules (N=8/12), fear of diagnosis (N=8/12), and, with economic pressures leading participants to prioritize work over health (N=8/12). However, strong familial motivations drive participants to take preventive health measures to avoid burdening their loved ones (N=7/12). Culturally tailored CRC prevention education programs should incorporate language and cultural relatability (n=10/12), storytelling (N=9/12),, and trusted medical authority (N=8/12).Conclusion. Addressing the identified barriers (limited knowledge) and leveraging strong family values will foster participation in CRC screening and participation in programs promoting screening. Personable and culturally tailored education that fosters emotional and relatable connections encourages participants' motivation and understanding of CRC to effectively reach Filipino communities in Hawaiʻi. Findings provide insight toward developing novel, culturally tailored interventions for Filipino families to increase CRC screening participation in this Asian community who experience screening disparities. Citation Format: Jena Funakoshi, Alisa Peralta, Marc Rollon, Tressa P. Diaz, Angela Sy. So much of everything is rooted and caring for the family:” Community-Informed Colorectal Cancer Screening Education Recommendations for Filipinos in Hawaiʻi [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A129.

Trends and Disparities in Mental Health Use Among Asian American Sub-groups, 2013-2019.

The objective of this study was to characterize and compare national estimates of mental healthcare use among White and Asian American groups to provide an update using post Affordable Care Act data. We analyzed yearly cross-sectional data from the 2013-2019 Medical Expenditure Panel Survey, including White (n=112,590) and Asian American (n=10,210) individuals, and examined rates of mental healthcare use for Asian (overall), Asian Indian, Chinese, Filipino, and Other Asian individuals relative to White individuals. Using multivariable logistic regression models and predictive margin methods, we estimated overall Asian disparities and Asian subgroup disparities compared to White group rates in mental health care (outpatient, specialty, psychotropic medication) among adults with and without elevated risk for mental illness. Regression models were adjusted for variables related to need for treatment, demographic, and socioeconomic status variables. Asian individuals had lower rates of mental healthcare use than White individuals. Unadjusted results and adjusted regression model predictions are consistent in identifying wide disparities in mental health care treatment across risk for mental illness, Asian subgroups, and types of treatment. Asian Americans have significantly lower rates of mental healthcare use than White Americans, even among those with elevated risk for mental illness. There is small variation by Asian subgroups but disparities persist across subgroups and types of treatment. Our results imply interventions are needed to improve linguistically, culturally, and ethnically tailored outreach and engagement in treatment services, as well as examining treatment and its effectiveness for Asian American individuals living with psychological distress.

Correlation of TNF-α polymorphisms with susceptibility to lung cancer: evidence from a meta-analysis based on 29 studies

ObjectiveThis meta-analysis aims to clarify the association between the TNF-α -308G > A and − 238G > A polymorphisms and lung cancer risk.MethodA comprehensive search was conducted for relevant articles across databases such as PubMed, Google Scholar, Web of Science, EMBASE, and CNKI, up to September 25, 2023. Lung cancer risk was assessed by calculating odds ratios (ORs) and their 95% confidence intervals (CIs). The Z-test was used to determine the significance of combined ORs, with P < 0.05 considered statistically significant. All analyses were performed using Comprehensive Meta-Analysis (CMA) 2.0 software.ResultsThe analysis included 19 case-control studies with 3,838 cases and 5,306 controls for the TNF-α -308G > A polymorphism, along with 10 studies comprising 2,427 cases and 2,357 controls for the − 238G > A polymorphism. The − 308G > A polymorphism showed no significant overall relationships, though in the Asian subgroup, the A allele was significantly reduced compared to G (OR: 0.831, p = 0.028) and the AA genotype showed significant reductions versus GG (OR: 0.571, p = 0.021), with no significant correlation in Caucasians. In non-small cell lung cancer (NSCLC), the A allele was associated with increased risk compared to G (OR: 1.131, p = 0.049). For the − 238G > A polymorphism, the AA genotype significantly increased risk compared to GG (OR: 3.171, p = 0.014), while showing a protective effect in Caucasians (OR: 0.120, p = 0.024) and a heightened risk in Asians (OR: 7.990, p = 0.007). In small cell lung cancer (SCLC), the A allele conferred protective effects, whereas NSCLC showed increased risk for the AA genotype (OR: 11.375, p = 0.002).ConclusionThe − 308G > A polymorphism has no significant overall relationships but suggests a protective role of the A allele in the Asian subgroup. Conversely, the − 238G > A polymorphism presents a complex risk profile, increasing lung cancer likelihood in Asians while protecting Caucasians. Notably, the AA genotype significantly raises risk for NSCLC, indicating its potential as a risk factor.

Cancer Screening, Knowledge, and Fatalism among Chinese, Korean, and South Asian Residents of New York City.

Asian New York City residents have the lowest cancer screening uptake across race and ethnicity. Few studies have examined screening differences across Asian ethnic subgroups in New York City. Cross-sectional survey data were analyzed using multivariable logistic and multinomial regression analyses. Differences among Chinese, Korean, and South Asian adults in breast, cervical, and colorectal cancer screening uptake; breast and colorectal cancer screening knowledge; and cancer fatalism were examined. Associations between breast and colorectal cancer screening knowledge and their uptake were also assessed along with associations between cancer fatalism and breast, cervical, and colorectal cancer screening uptake. Korean women reported 0.52 times [95% confidence interval (CI), 0.31-0.89] lower odds of Pap test uptake compared with Chinese women; South Asian adults had 0.43 times (95% CI, 0.24-0.79) lower odds of colorectal cancer screening uptake compared with Chinese adults. Korean adults reported 1.80 times (95% CI, 1.26-2.58) higher odds of knowing the correct age to begin having mammograms compared with Chinese adults; South Asian adults had 0.67 times (95% CI, 0.47-0.96) lower odds of knowing the correct age to begin colorectal cancer screening compared with Chinese adults. Korean adults had 0.37 times (95% CI, 0.27-0.53) lower odds of reporting cancer fatalism compared with Chinese adults. Low cancer screening uptake among Asian American adults, low screening knowledge, and high cancer fatalism were found. Cancer screening uptake, knowledge, and fatalism varied by ethnic subgroup. Findings indicate the need for ethnicity-specific cultural and linguistic tailoring for future cancer screening interventions.