Improved survival of Asians with corpus cancer compared with whites: an analysis of underlying factors.

Abstract:

OBJECTIVE:To compare the clinicopathologic prognosticators and survival of Asians and whites with corpus cancer. METHODS:Demographic, clinicopathologic, and survival data were obtained from the 1992-2001 Surveillance, Epidemiology, and End Results Program. Statistical analyses were performed by Kaplan-Meier methods and Cox proportional hazards model. RESULTS:A total of 2,144 Asians and 32,999 whites with corpus cancer were identified. The age-adjusted incidence of uterine cancer in Asians compared with whites was 16.8 compared with 26.1 per 100,000. Asians presented at a younger age (mean 58.4 years compared with 65.1; P < .01) and with more advanced stage disease than whites (21.5% compared with 15.4%; P < .01). The 5-year survival rate for Asians was 79.4% compared with 75.2% for whites (P < .01). Asians with stage I-II and III-IV cancers had 5-year survival rates of 89.3% and 41.2% compared with 82.3% and 34.0% for the whites, respectively (P < .01, early stage; P < .01, advanced stage). The survival advantage of Asians persists in endometrioid (P < .01) and uterine papillary serous carcinomas (P < .01), but not in clear cell carcinoma (P = .62) or sarcomas (P = .78). In multivariate analysis, younger age (P < .01), earlier stage (P < .01), favorable histology (P < .01), and lower grade (P < .01) remained as significant independent prognosticators for improved survival. However, race was not an important prognosticator. CONCLUSION:The overall survival advantage experienced by Asians with uterine cancer is attributable to their younger age at diagnosis. Because Asian women present at a younger age with more advanced disease, physicians should have an increased index of suspicion for malignancy in young Asian women with suspicious symptoms and consider a lower age threshold for biopsy in this group. LEVEL OF EVIDENCE:II-2.

journal_name

Obstet Gynecol

authors

Zhang MM,Cheung MK,Osann K,Lee MM,Gomez SS,Whittemore AS,Husain A,Teng NN,Chan JK

doi

10.1097/01.AOG.0000195062.75199.7d

subject

Has Abstract

pub_date

2006-02-01 00:00:00

pages

329-35

issue

2 Pt 1

eissn

0029-7844

issn

1873-233X

pii

107/2/329

journal_volume

107

pub_type

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