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Endoscopic History and Provider Characteristics Influence Gastric Cancer Survival in Asian Americans.
Jeon, Christie Y; Lin, Yu-Chen; Klempner, Samuel J; Wu, Bechien U; Kim, Sungjin; Waters, Kevin M; Haile, Robert W.
Afiliación
  • Jeon CY; Cedars-Sinai Medical Center, Los Angeles, California. christie.jeon@cshs.org.
  • Lin YC; Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, Los Angeles, California.
  • Klempner SJ; Cedars-Sinai Medical Center, Los Angeles, California.
  • Wu BU; Division of Hematology-Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, Massachusetts.
  • Kim S; Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
  • Waters KM; Cedars-Sinai Medical Center, Los Angeles, California.
  • Haile RW; Cedars-Sinai Medical Center, Los Angeles, California.
Cancer Prev Res (Phila) ; 13(9): 773-782, 2020 09.
Article en En | MEDLINE | ID: mdl-32561562
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.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Carcinoma / Tamizaje Masivo / Gastroscopía / Disparidades en Atención de Salud Tipo de estudio: Diagnostic_studies / Prognostic_studies / Screening_studies Aspecto: Determinantes_sociais_saude Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Cancer Prev Res (Phila) Asunto de la revista: NEOPLASIAS Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Carcinoma / Tamizaje Masivo / Gastroscopía / Disparidades en Atención de Salud Tipo de estudio: Diagnostic_studies / Prognostic_studies / Screening_studies Aspecto: Determinantes_sociais_saude Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Cancer Prev Res (Phila) Asunto de la revista: NEOPLASIAS Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos