Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Michael S. Leapman

Abstract

Introduction: Given the considerable cultural diversity within the Asian population, numerous factors can significantly impact health status and management. Objective: This study examined the differences in demographic characteristics, clinical characteristics, and treatment status among each Asian American patient with PCa compared to non-Hispanic White and non-Hispanic Black patients by analyzing PCa dataset from National Cancer Database (NCDB) 2004-2020 data. Methods: Patients (n=860,669) with localized PCa diagnosed between 2004 and 2020 who identified as White, Black, Chinese, Japanese, Filipino, Korean, Vietnamese, Asian Indian, or Pakistani within NCDB were extracted and stratified by risk level: low-risk and intermediate/high-risk. The effect of racial group on the mode of initial clinical management was examined using five multivariate logistic regression models. The odds ratios were converted to relative risks. Results: Among low-risk patients, Vietnamese (RR=1.38; 95%CI=1.14-1.63), Chinese (RR=1.30; 95%CI=1.16-1.43), and South Asian (RR=1.23; 95%CI=1.11-1.34) identity was associated with increased use of non-definitive treatment options compared to non-Hispanic White patients. Among intermediate or high-risk patients, Japanese patients (RR=1.09; 95% CI= 1.06-1.13) and Chinese (RR=1.04; 95% CI=1.01-1.07) identity was associated with increased use of definitive treatment options compared to non-Hispanic White; whereas 9% decrease was observed in non-Hispanic Black patients (RR=0.91; 95% CI=0.90-0.92) compared to non-Hispanic White. Conclusions: This study identified notable differences in demographic and clinical characteristics at the time of prostate cancer diagnosis, as well as variations in clinical management. Despite these differences in demographic and clinical characteristics, patients with intermediate and high-risk prostate cancer exhibited minimal variability in their treatment status.

Comments

This is an Open Access Thesis.

Open Access

This Article is Open Access

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