Background
Endometrial cancer is the fourth most common cancer in the United States females. While the disparity in the outcomes of this cancer has been studied extensively among other minority populations, it has not yet been studied for Asian Indian and Pakistani American populations (AIPAs)- one of the fastest-growing major ethnic groups.
Methods
We utilized the SEER database to derive disease characteristics, therapy, and survival data for AIPA and Non-Hispanic White women aged 18 years and above from 2000 to 2018. Baseline characteristics were compared among these groups. Univariate survival analysis was done using a Kaplan Meier plot with a log-rank test, and the Cox proportional-hazards model was used for multivariate survival analysis.
Results
A total of 116,883 cases were included - among which 115,840 were NHW and 1043 were AIPAs. Among AIPAs, 619 (59%) were Asian Indians, 362 (35%) were Indian/Pakistanis, not specified, and 62 (6%) were Pakistanis. AIPAs were significantly younger at diagnosis (Median age: 60 and 63 years, p = 0.00). Endometroid carcinoma was the most common cancer. When compared, 87% of AIPA and 91% of NHW had endometroid cancer. Likewise, serous cell carcinoma was seen in 11% AIPAs and 8% of the NHW population. Endometroid cancer was more common compared to serous cell cancer among NHW when compared to AIPAs (p < 0.001). AIPAs were less likely to receive chemotherapy than NHW (81% and 86%, p = 0.000). AIPAs were found to have better survival than NHW in univariate analysis (p=0.0001) and multivariate analysis after adjusting other co-variates (HR = 0.68, CI: 0.72 - 0.98, p = 0.04).
Conclusion
AIPA women had better survival than the NHW population with endometrial cancer when adjusted for covariates. But there remains a need to define further the unique characteristics of endometrial cancer in AIPA women.