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Endoscopic history and provider characteristics influence gastric cancer survival in Asian Americans
Cancer Prevention Research ( IF 3.3 ) Pub Date : 2020-06-19 , DOI: 10.1158/1940-6207.capr-20-0058
Christie Y Jeon 1, 2 , Yu-Chen Lin 1 , Samuel J Klempner 3 , Bechien U Wu 4 , Sungjin Kim 1 , Kevin M Waters 1 , Robert W Haile 1
Affiliation  

Gastric carcinoma (GC) disproportionately affects Asian Americans. We examined whether history of upper gastrointestinal (GI) endoscopy was associated with lower stage at GC diagnosis among Asian Americans and whether origin of providers influenced referral for endoscopy. We employed Surveillance Epidemiology and End Results–Medicare data on Asian Americans diagnosed with GC in 2004–2013 (n = 1,554). Stage distribution, GI conditions at diagnosis, and history of endoscopy were compared between Asian ethnic groups. Multivariate logistic regression adjusting for age, sex, poverty level, tumor location, and histology was used to examine the association of ethnicity and endoscopic history with stage I disease at diagnosis of GC. Koreans were more likely to be diagnosed with stage I, T1a GC and have prior history of endoscopy, compared with other Asian ethnicities (24% vs. 8% for stage I, T1a; 40% vs. 15% for endoscopy). Patients with primary care providers of concordant ethnic origin were more likely to have history of endoscopy. Asian American patients with GC with history of endoscopy were more likely to be diagnosed with GC at stage I disease (adjusted OR, 3.07; 95% confidence interval, 2.34–4.02). Compared with other Asian Americans, Koreans were diagnosed with GC at earlier stages owing to common history of endoscopy, which was more often undergone by patients with primary care providers of concordant ethnic origin. Overall, upper GI endoscopy was associated with early detection of GC in Asian Americans. Novelty and Impact. It is well-established that Asian Americans in the United States are disproportionately affected by gastric cancer. In our study we found that Asian American patients treated by physicians of similar ethnic background are more likely to undergo upper GI endoscopy in the United States, leading to early detection of gastric cancer and longer survival. Given this, targeted endoscopic screening in Asian Americans should be considered for early detection of GC.

中文翻译:

内窥镜病史和提供者特征影响亚裔美国人的胃癌存活率

胃癌 (GC) 不成比例地影响亚裔美国人。我们检查了上消化道 (GI) 内窥镜检查的历史是否与亚裔美国人的 GC 诊断的较低阶段相关,以及提供者的来源是否影响内窥镜检查的转诊。我们对 2004-2013 年诊断为 GC 的亚裔美国人(n = 1,554)使用了流行病学监测和最终结果–医疗保险数据。比较亚洲种族之间的分期分布、诊断时的胃肠道状况和内窥镜检查史。使用针对年龄、性别、贫困水平、肿瘤位置和组织学进行调整的多变量逻辑回归来检查种族和内窥镜病史与 GC 诊断时 I 期疾病的关联。韩国人更有可能被诊断为 I 期、T1a GC 并且有内窥镜检查史,与其他亚洲种族相比(I 期 T1a 为 24% 与 8%;内窥镜检查为 40% 与 15%)。具有一致种族血统的初级保健提供者的患者更有可能有内窥镜检查史。有内窥镜检查史的亚裔美国人更容易在 I 期诊断为 GC(调整后的 OR,3.07;95% 置信区间,2.34-4.02)。与其他亚裔美国人相比,韩国人因内窥镜检查的常见病史而在较早阶段被诊断出患有 GC,而内窥镜检查通常由具有一致种族血统的初级保健提供者的患者进行。总体而言,上消化道内窥镜检查与亚裔美国人早期发现 GC 相关。新颖性和影响力。众所周知,美国的亚裔美国人受到胃癌的影响不成比例。在我们的研究中,我们发现由具有相似种族背景的医生治疗的亚裔美国患者更有可能在美国接受上消化道内窥镜检查,从而可以及早发现胃癌并延长生存期。鉴于此,应考虑对亚裔美国人进行靶向内窥镜筛查以早期发现 GC。
更新日期:2020-06-19
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