Characterizing disparities in receipt of palliative care for Asian Americans, Native Hawaiians, and Pacific Islanders with metastatic cancer in the United States Journal Article

  


Authors: Kohli, K.; Kohli, M.; Jain, B.; Swami, N.; Ranganathan, S.; Chino, F.; Iyengar, P.; Yerramilli, D.; Dee, E. C.
Article Title: Characterizing disparities in receipt of palliative care for Asian Americans, Native Hawaiians, and Pacific Islanders with metastatic cancer in the United States
Abstract: Purpose: Palliative care plays essential roles in cancer care. However, differences in receipt among individuals identifying as Asian American, Native Hawaiian, and Other Pacific Islanders (AA&NHPI) with cancer are not well-characterized, especially when these diverse groups are disaggregated. We characterized disparities in receipt of palliative care among AA&NHPI patients with AJCC Stage IV prostate, breast, or lung cancer. Methods: We performed multivariable logistic regressions were performed in this retrospective cohort analysis, using deidentified data from the National Cancer Database (NCDB) of patients diagnosed with AJCC analytic group stage IV breast, lung, or prostate cancer (2004–2018) who were White or of Asian Indian/Pakistani, Chinese, Filipino, Hawaiian, Hmong, Japanese, Kampuchean, Korean, Laotian, Other Pacific Islander, Thai, or Vietnamese descent. We conducted multivariable logistic regression analyses in a retrospective cohort study using deidentified data from the National Cancer Database (NCDB). The study included patients diagnosed with AJCC analytic group Stage IV breast, lung, or prostate cancer between 2004 and 2018, who were White or identified as Asian Indian/Pakistani, Chinese, Filipino, Hawaiian, Hmong, Japanese, Kampuchean, Korean, Laotian, Other Pacific Islander, Thai, or Vietnamese descent. Adjusted odds ratios and 95% confidence intervals of receiving palliative care were measured when comparing White vs. AA&NHPI patients as one cohort and White vs. disaggregated AA&NHPI patients, adjusting for clinical, socioeconomic, and demographic covariates. Results: Among 775,289 individuals diagnosed with cancer (median age: 68 years), no significant differences in palliative care receipt were observed between White patients and aggregated AA&NHPI patients among patients with prostate, breast, or lung cancer. However, disaggregated analyses revealed reduced palliative care receipt for breast cancer patients of Asian Indian/Pakistani descent (AOR 0.75, 95% CI, 0.60–0.94, P = 0.011) and for lung cancer patients of Chinese, Vietnamese, Thai, and Asian Indian/Pakistani descent compared to White patients (Chinese AOR 0.88, [0.81–0.94], P = 0.001; Vietnamese AOR 0.89, [0.80 to 0.99], P = 0.032; Thai AOR 0.64, [0.44–0.92], P = 0.016; Asian Indian/Pakistani AOR 0.83, [0.74–0.93], P = 0.001). Palliative care was greater for patients of Japanese and Hawaiian descent with prostate cancer (Japanese AOR 1.92, [1.32–2.75], P = 0.001; Hawaiian AOR 2.09, [1.20–3.66], P = 0.009), breast cancer (Japanese AOR 1.72, [1.21–2.43], P = 0.001; Hawaiian AOR 1.70, [1.08–2.67], P = 0.021), and lung cancer (Japanese AOR 1.92, [1.70–2.17], P < 0.001; Hawaiian AOR 2.95, [2.5–3.5], P < 0.001), as well as patients of Other Pacific Islander descent with lung cancer (AOR 1.62, [1.34–1.96], P < 0.001). Conclusions and relevance: Our findings demonstrate disparities in receipt of palliative care upon disaggregation of diverse AA&NHPI groups, the need for disaggregated research and targeted interventions that address the unique cultural, socioeconomic, and healthcare system barriers to palliative care receipt. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
Keywords: adult; cancer chemotherapy; controlled study; aged; aged, 80 and over; middle aged; cancer surgery; retrospective studies; major clinical study; united states; cancer radiotherapy; antineoplastic agent; neoplasm; neoplasms; cancer palliative therapy; palliative care; metastasis; cohort studies; breast cancer; logistic models; lung neoplasms; palliative therapy; cohort analysis; lung cancer; pathology; breast neoplasms; retrospective study; prostate cancer; prostatic neoplasms; lung tumor; breast tumor; prostate tumor; neoplasm metastasis; statistical model; therapy; metastatic; asian american; pacific islander; health care disparity; ethnology; asian; chinese; healthcare disparities; disparities; oceanic ancestry group; very elderly; cancer; humans; human; male; female; article; malignant neoplasm; filipino (people); korean (people); vietnamese; pakistani; native hawaiian or other pacific islander; native hawaiian; laotian; thai (people); aa&nhpi; hawaiian (citizen)
Journal Title: Supportive Care in Cancer
Volume: 32
Issue: 8
ISSN: 0941-4355
Publisher: Springer Verlag  
Date Published: 2024-08-01
Start Page: 494
Language: English
DOI: 10.1007/s00520-024-08633-w
PUBMED: 38977496
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85197744710&doi=10.1007%2fs00520-024-08633-w&partnerID=40&md5=c35cb77b00a00e1d1135dc5f8e5a01e0
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Edward Christopher Dee -- Source: Scopus
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MSK Authors
  1. Fumiko Chino
    223 Chino
  2. Divya Yerramilli
    49 Yerramilli
  3. Edward Christopher Dee
    253 Dee
  4. Puneeth Iyengar
    41 Iyengar
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