15018 Background: Asians and Pacific Islanders (APIs) have increased risk of developing gastric cancer, but whether cancer treatments and outcomes vary by birthplace is unknown. We examined the association between birthplace and cancer stage at diagnosis, treatment, and survival comparing API and non-Hispanic white (NHW) patients. Methods: We studied 6840 NHW and 4485 API patients diagnosed with gastric cancer from the Surveillance, Epidemiology and End Results Program between 1992 and 2003. We used bivariable analyses to compare stage, receipt of adequate lymph node assessment and surgery across groups: US-born APIs, foreign-born (FB) APIs and NHWs. We used multivariable polychotomous logistic and proportional hazards regression models to determine differences between US-born and FB APIs compared to NHWs in cancer stage and survival, respectively. Models included age, marital status, tumor grade, location, and stage (survival only). Results: Of API patients, 29% were US-born, 49% FB and 22% of unknown birthplace. APIs were more likely than NHWs to present with earlier-stage diagnoses and receive surgery and adequate lymph node assessment (p<0. 001). After adjustment, US-born [aOR=0.86 (0.75–0.93)] and FB APIs [aOR=0.76 (0.68–0.84)] were less likely to present at later stages than NHWs. Among APIs, FB patients had fewer lymph node assessed than US-born (p<0.001), but were as likely to present with earlier stage disease and receive surgery. After adjustment, US-born [aHR= 0.90 (0.85–0.98)] and FB APIs [(aHR= 0.85 (0.78–0.92)] had higher survival rates than NHWs. Results were similar after adjusting for treatment. *p <0.001 for comparison with NHW +p>0.05 for comparison among API Conclusions: Compared to US-born APIs, FB API patients with gastric cancer present at later stages and are less likely to receive adequate surgical lymph node assessment. However, both US-born and FB API patients present at earlier stages and experience better survival than non-Hispanic white patients. [Table: see text] No significant financial relationships to disclose.
Two-month stop in mammographic screening significantly impacts on breast cancer stage at diagnosis and upfront treatment in the COVID era