Survival following Non-Small Cell Lung Cancer among Asian/Pacific Islander, Latina, and Non-Hispanic White Women Who Have Never Smoked

Lung cancer is the leading cause of cancer death among U.S. Asian/Pacific Islander (API) and Latina women despite low smoking prevalence. This study examined survival patterns following non-small cell lung cancer in a population-based sample of lung cancer cases from the San Francisco Bay Area Lung...

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Published in:Cancer epidemiology, biomarkers & prevention biomarkers & prevention, 2011-03, Vol.20 (3), p.545-554
Main Authors: GOMEZ, Scarlett L, CHANG, Ellen T, SHEMA, Sarah J, FISH, Kari, SISON, Jennette D, REYNOLDS, Peggy, CLEMENT-DUCHENE, Christelle, WRENSCH, Margaret R, WIENCKE, John L, WAKELEE, Heather A
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
California - epidemiology
Carcinoma, Non-Small-Cell Lung - ethnology
Carcinoma, Non-Small-Cell Lung - mortality
European Continental Ancestry Group
Female
Follow-Up Studies
Hispanic Americans - ethnology
Humans
Lung Neoplasms - ethnology
Lung Neoplasms - mortality
Medical sciences
Middle Aged
Oceanic Ancestry Group - ethnology
Pneumology
Smoking - epidemiology
Survival Rate
Tumors
Tumors of the respiratory system and mediastinum
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Summary:Lung cancer is the leading cause of cancer death among U.S. Asian/Pacific Islander (API) and Latina women despite low smoking prevalence. This study examined survival patterns following non-small cell lung cancer in a population-based sample of lung cancer cases from the San Francisco Bay Area Lung Cancer Study (SFBALCS). Women diagnosed with lung cancer from 1998 to 2003 and 2005 to 2008 and identified through the Greater Bay Area Cancer Registry were telephone-screened for eligibility for the SFBALCS. The screener data were linked to the cancer registry data to determine follow-up. This analysis included 187 non-Hispanic (NH) white, 23 U.S.-born Latina, 32 foreign-born Latina, 30 U.S.-born API, and 190 foreign-born API never-smokers diagnosed with lung cancer and followed through 2008. All-cause survival was poorer among APIs [HR=1.7 (95% CI: 1.0-2.8) among U.S.-born APIs and HR=1.2 (95% CI: 0.9-1.5) among foreign-born APIs] and Latinas [HR=2.1 (95% CI: 1.2-3.6) among U.S.-born Latinas; HR=1.4 (95% CI: 0.9-2.3) among foreign-born Latinas] relative to NH whites. These survival differences were not explained by differences in selected sociodemographic or clinical factors. Further research should focus on factors such as cultural behaviors, access to or attitudes toward health care, and genetic variations as possible explanations for these striking racial/ethnic differences. Latina and API female never-smokers diagnosed with lung cancer were up to two times more likely to die than NH whites, highlighting the need for additional research to identify the underlying reasons for the disparities and heightened clinical awareness.
ISSN:1055-9965
1538-7755
DOI:10.1158/1055-9965.EPI-10-0965