Abstract
e17578
Background: Ovarian cancer represents a leading cancer-related cause of death among women in the United States, with approximately 20,890 new cases expected to be diagnosed in 2025. Studies have demonstrated that by race, White women are more likely than Black women to develop ovarian cancer, with incidence of Asian women falling in between the two groups. Historically, the Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations have often been studied together as a homogeneous cohort, masking heterogeneity in health behaviors and socioeconomic status. Our goal is to compare disaggregated survival among AANHPI women with non-Hispanic White (NHW) women with ovarian cancer in the United States. Methods: The National Cancer Database was queried between 2004-2022 for patients with epithelial ovarian cancer. AANHPI patients were further disaggregated into subgroups, and non-Hispanic White patients were included as reference. Survival curves were generated using Kaplan-Meier estimates, and multivariate analyses were conducted using Cox regression models. Results: A total of 7,803 AANHPI patients were included along with 212,441 NHW patients. AANHPI patients were then categorized into subgroups consisting of 2,909 East Asian (EA), 1,901 South Asian (SA), 2,455 Southeast Asian (SEA), and 538 Native Hawaiian and other Pacific Islander (NHPI). Compared with NHW, AANHPI experienced longer survival times (128.46 months vs. 95.17 months, p < 0.001). Upon disaggregation, EA patients experienced better survival (128.94 months) than both SEA (121.67 months, p < 0.032) and NHPI (114.77 months, p < 0.047) groups. SA patients were also noted to have better survival (131.75 months) than both their SEA (121.67 months, p-value) and NHPI patients (114.77 months, p-value). Additionally, Cox regression demonstrated SEA and NHPI had higher risk of death compared to EA (HR 1.137, 95% CI 1.036-1.248 and HR 1.334, 95% CI 1.135-1.568.) Conclusions: AANHPI women with epithelial ovarian cancer experienced better survival as a cohort relative to NHW women. However, when disaggregated, there were notable disparities among different subgroups. Patterns of survival rate were heterogeneous, with SEA and NHPI subgroups at highest risk of ovarian cancer death. AANHPI represents a diverse group of individuals, and it is imperative for physicians, researchers, and policy makers to appreciate the true heterogeneity of this population. This understanding will lend to greater overall equity as we aim to target disparities across ethnic cohorts.