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PSA, stage, grade and prostate cancer specific mortality in Asian American patients relative to Caucasians according to the United States Census Bureau race definitions.
World J Urol. 2020 May 26 [Online ahead of print]WJ

Abstract

BACKGROUND

The United States Census Bureau recommends distinguishing between "Asians" vs. "Native Hawaiians or Other Pacific Islanders" (NHOPI). We tested for prognostic differences according to this stratification in patients with prostate cancer (PCa) of all stages.

METHODS

Descriptive statistics, time-trend analyses, Kaplan-Meier plots and multivariate Cox regression models were used to test for differences at diagnosis, as well as for cancer specific mortality (CSM) according to the Census Bureau's definition in either non-metastatic or metastatic patients vs. 1:4 propensity score (PS)-matched Caucasian controls, identified within the Surveillance, Epidemiology and End Results database (2004-2016).

RESULTS

Of all 380,705 PCa patients, NHOPI accounted for 1877 (0.5%) vs. 23,343 (6.1%) remaining Asians vs. 93.4% Caucasians. NHOPI invariably harbored worse PCa characteristics at diagnosis. The rates of PSA ≥ 20 ng/ml, Gleason ≥ 8, T3/T4, N1- and M1 stages were highest for NHOPI, followed by Asians, followed by Caucasians (PSA ≥ 20: 18.4 vs. 14.8 vs. 10.2%, Gleason ≥ 8: 24.9 vs. 22.1, vs. 15.9%, T3/T4: 5.5 vs. 4.2 vs. 3.5%, N1: 4.4 vs. 2.8, vs. 2.7%, M1: 8.3 vs. 4.9 vs. 3.9%). Despite the worst PCa characteristics at diagnosis, NHOPI did not exhibit worse CSM than Caucasians. Moreover, despite worse PCa characteristics, Asians exhibited more favorable CSM than Caucasians in comparisons that focussed on non-metastatic and on metastatic patients.

CONCLUSIONS

Our observations corroborate the validity of the distinction between NHOPI and Asian patients according to the Census Bureau's recommendation, since these two groups show differences in PSA, grade and stage characteristics at diagnosis in addition to exhibiting differences in CSM even after PS matching and multivariate adjustment.

Authors+Show Affiliations

Department of Urology, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany. Marina.Deuker@kgu.de. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. Marina.Deuker@kgu.de.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. European Institute of Oncology, Milan, Italy.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.Department of Urology, University Hospital Frankfurt, Theodor-Stern Kai 7, 60590, Frankfurt am Main, Germany.Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32458094

Citation

Deuker, Marina, et al. "PSA, Stage, Grade and Prostate Cancer Specific Mortality in Asian American Patients Relative to Caucasians According to the United States Census Bureau Race Definitions." World Journal of Urology, 2020.
Deuker M, Stolzenbach LF, Pecoraro A, et al. PSA, stage, grade and prostate cancer specific mortality in Asian American patients relative to Caucasians according to the United States Census Bureau race definitions. World J Urol. 2020.
Deuker, M., Stolzenbach, L. F., Pecoraro, A., Rosiello, G., Luzzago, S., Tian, Z., Saad, F., Chun, F. K., & Karakiewicz, P. I. (2020). PSA, stage, grade and prostate cancer specific mortality in Asian American patients relative to Caucasians according to the United States Census Bureau race definitions. World Journal of Urology. https://doi.org/10.1007/s00345-020-03242-8
Deuker M, et al. PSA, Stage, Grade and Prostate Cancer Specific Mortality in Asian American Patients Relative to Caucasians According to the United States Census Bureau Race Definitions. World J Urol. 2020 May 26; PubMed PMID: 32458094.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - PSA, stage, grade and prostate cancer specific mortality in Asian American patients relative to Caucasians according to the United States Census Bureau race definitions. AU - Deuker,Marina, AU - Stolzenbach,L Franziska, AU - Pecoraro,Angela, AU - Rosiello,Giuseppe, AU - Luzzago,Stefano, AU - Tian,Zhe, AU - Saad,Fred, AU - Chun,Felix K-H, AU - Karakiewicz,Pierre I, Y1 - 2020/05/26/ PY - 2020/03/07/received PY - 2020/05/05/accepted PY - 2020/5/28/entrez KW - AANHPI KW - AAPI KW - NHOPI KW - Native Hawaiian KW - Pacific Islander KW - Prostate cancer survival KW - Racial disparities KW - SEER JF - World journal of urology JO - World J Urol N2 - BACKGROUND: The United States Census Bureau recommends distinguishing between "Asians" vs. "Native Hawaiians or Other Pacific Islanders" (NHOPI). We tested for prognostic differences according to this stratification in patients with prostate cancer (PCa) of all stages. METHODS: Descriptive statistics, time-trend analyses, Kaplan-Meier plots and multivariate Cox regression models were used to test for differences at diagnosis, as well as for cancer specific mortality (CSM) according to the Census Bureau's definition in either non-metastatic or metastatic patients vs. 1:4 propensity score (PS)-matched Caucasian controls, identified within the Surveillance, Epidemiology and End Results database (2004-2016). RESULTS: Of all 380,705 PCa patients, NHOPI accounted for 1877 (0.5%) vs. 23,343 (6.1%) remaining Asians vs. 93.4% Caucasians. NHOPI invariably harbored worse PCa characteristics at diagnosis. The rates of PSA ≥ 20 ng/ml, Gleason ≥ 8, T3/T4, N1- and M1 stages were highest for NHOPI, followed by Asians, followed by Caucasians (PSA ≥ 20: 18.4 vs. 14.8 vs. 10.2%, Gleason ≥ 8: 24.9 vs. 22.1, vs. 15.9%, T3/T4: 5.5 vs. 4.2 vs. 3.5%, N1: 4.4 vs. 2.8, vs. 2.7%, M1: 8.3 vs. 4.9 vs. 3.9%). Despite the worst PCa characteristics at diagnosis, NHOPI did not exhibit worse CSM than Caucasians. Moreover, despite worse PCa characteristics, Asians exhibited more favorable CSM than Caucasians in comparisons that focussed on non-metastatic and on metastatic patients. CONCLUSIONS: Our observations corroborate the validity of the distinction between NHOPI and Asian patients according to the Census Bureau's recommendation, since these two groups show differences in PSA, grade and stage characteristics at diagnosis in addition to exhibiting differences in CSM even after PS matching and multivariate adjustment. SN - 1433-8726 UR - https://www.unboundmedicine.com/medline/citation/32458094/PSA,_stage,_grade_and_prostate_cancer_specific_mortality_in_Asian_American_patients_relative_to_Caucasians_according_to_the_United_States_Census_Bureau_race_definitions L2 - https://dx.doi.org/10.1007/s00345-020-03242-8 DB - PRIME DP - Unbound Medicine ER -
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