Prognostic factors in Asian and white American patients with cervical cancer, considering competing risks

  • Y. Hou College of Economics, Jinan University
  • S. Guo School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University
  • J. Lyu School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University
  • Z. Lu Dalla Lana School of Public Health, University of Toronto, SickKids Research Institute, Hospital for Sick Children
  • Z. Yang School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University
  • D. Liu Second Affiliated Hospital of Xi’an Jiaotong University
  • Z. Chen School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University
Keywords: Cervical neoplasms, prognosis, cause of death, competing risks

Abstract

Background Cervical cancer is the 2nd most common malignant tumour in women worldwide. Previous research studies have given little attention to its prognostic factors in the rapidly growing Asian American population. In the present study, we explored prognostic factors in Asian and white American patients with cervical cancer, considering competing risks.

Methods The study included 58,780 patients with cervical cancer, of whom 54,827 were white and 3953 were Asian American, and for all of whom complete clinical information was available in the U.S. Surveillance, Epidemiology, and End Results database. Death from cervical cancer was considered to be the event of interest, and deaths from other causes were defined as competing risks. The cumulative incidence function and the Fine–Gray method were applied for univariate and multivariate analysis respectively.

Results We found that, for all patients (white and Asian American combined), the cumulative incidence function was associated with several factors, such as age at diagnosis, figo (Fédération internationale de Gynécologie et d’Obstétrique) stage, registry area, and lymph node metastasis. Similar results were found when considering white patients only. However, for Asian American patients, registry area was not associated with the cumulative incidence function, but the other factors (for example, figo stage) remained statistically significant. Similarly, in multivariate analyses, we found that age at diagnosis, figo stage, lymph node metastasis, tumour histology, treatment method, and race were all associated with prognosis.

Conclusions Survival status differs for white and Asian American patients with cervical cancer. Our results could guide the treatment of, and facilitate prognostic judgments about, white and Asian American patients with cervical cancer.

Author Biographies

Y. Hou, College of Economics, Jinan University

Department of Statistics

 

 

S. Guo, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University
Department of Biostatistics
J. Lyu, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University
Department of Biostatistics
Z. Lu, Dalla Lana School of Public Health, University of Toronto, SickKids Research Institute, Hospital for Sick Children

Division of Biostatistics

Z. Yang, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University
Department of Biostatistics
D. Liu, Second Affiliated Hospital of Xi’an Jiaotong University
Department of Oncology
Z. Chen, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University
Department of Biostatistics
Published
2019-06-25
How to Cite
Hou, Y., Guo, S., Lyu, J., Lu, Z., Yang, Z., Liu, D., & Chen, Z. (2019). Prognostic factors in Asian and white American patients with cervical cancer, considering competing risks. Current Oncology, 26(3). https://doi.org/10.3747/co.26.4473
Section
Cancer Control and Prevention