George S Hagopian1, Molly Lieber2, Peter R Dottino3, M Margaret Kemeny4, Xilian Li5, Jessica Overbey6, Li-Duen Clark7, Ann Marie Beddoe8. 1. Department of Obstetrics and Gynecology, Elmhurst Hospital Center, Elmhurst, Queens, NY, United States; Department of Obstetrics and Gynecology, Queens Hospital Center, Jamaica, Queens, NY, United States; Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Queens Cancer Center, Queens Hospital Center, Jamaica, Queens, NY, United States. Electronic address: hagopiag@nychhc.org. 2. Division of Global Health, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, NY, New York, United States. 3. Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States. 4. Queens Cancer Center, Queens Hospital Center, Jamaica, Queens, NY, United States; Department of Surgery, Icahn School of Medicine at Mount Sinai, NY, New York, United States. 5. Department of Radiation Oncology, Queens Hospital Center, United States; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, NY, New York, United States. 6. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, New York, United States. 7. Department of Obstetrics and Gynecology, Queens Hospital Center, Jamaica, Queens, NY, United States. 8. Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Division of Global Health, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, NY, New York, United States.
Abstract
OBJECTIVE: We studied cervical cancer patients who presented to the Public Hospital System in ethnically-diverse Queens, New York from 2000 to 2010 with the purpose of examining the relationship between nativity (birthplace) and survival. METHODS: A retrospective review of tumor registries was used to identify patients diagnosed with cervical cancer between January 1, 2000 and December 31, 2010. Using electronic medical records, data from 317 patients were available for this analysis. RESULTS: The majority of patients were born outside the United States (US) (85.5% versus 14.5%). One hundred patients (31.5%) were born in Latin America, 105 in the Caribbean Islands (33.1%), 48 in Asia (15.1%), 8 in the South Asia (2.5%), 10 in Russia/Eastern Europe (3.2%) and 46 (14.5%) in the United States. Patients presented at varying stages of disease: 51.4% at stage I, 19.6% at stage II, 19.6% at stage III, and 8.5% at stage IV. Kaplan-Meier estimated survival curves stratified by birthplace demonstrated significant differences in survival distributions among the groups using the log-rank test (P<0.0001). The most favorable survival curves were observed among patients born in Latin America and Asia whereas the least favorable was demonstrated in US-born patients. Time to death was analyzed using the Cox proportional hazards model. Adjusting for age at diagnosis, insurance status, stage and treatment modality, nodal metastases and hydronephrosis, birthplace was significantly associated with survival time (P<0.0001). CONCLUSION: An immigrant health paradox was defined for foreign-born Latino and Asian patients presenting with cervical cancer to the Public Hospital System of Queens, New York as patients born in Latin America and Asia were less likely to die at any given time compared to those born in the United States.
OBJECTIVE: We studied cervical cancerpatients who presented to the Public Hospital System in ethnically-diverse Queens, New York from 2000 to 2010 with the purpose of examining the relationship between nativity (birthplace) and survival. METHODS: A retrospective review of tumor registries was used to identify patients diagnosed with cervical cancer between January 1, 2000 and December 31, 2010. Using electronic medical records, data from 317 patients were available for this analysis. RESULTS: The majority of patients were born outside the United States (US) (85.5% versus 14.5%). One hundred patients (31.5%) were born in Latin America, 105 in the Caribbean Islands (33.1%), 48 in Asia (15.1%), 8 in the South Asia (2.5%), 10 in Russia/Eastern Europe (3.2%) and 46 (14.5%) in the United States. Patients presented at varying stages of disease: 51.4% at stage I, 19.6% at stage II, 19.6% at stage III, and 8.5% at stage IV. Kaplan-Meier estimated survival curves stratified by birthplace demonstrated significant differences in survival distributions among the groups using the log-rank test (P<0.0001). The most favorable survival curves were observed among patients born in Latin America and Asia whereas the least favorable was demonstrated in US-born patients. Time to death was analyzed using the Cox proportional hazards model. Adjusting for age at diagnosis, insurance status, stage and treatment modality, nodal metastases and hydronephrosis, birthplace was significantly associated with survival time (P<0.0001). CONCLUSION: An immigrant health paradox was defined for foreign-born Latino and Asian patients presenting with cervical cancer to the Public Hospital System of Queens, New York as patients born in Latin America and Asia were less likely to die at any given time compared to those born in the United States.
Authors: Luceta McRoy; Josué Epané; Zo Ramamonjiarivelo; Ferhat Zengul; Robert Weech-Maldonado; George Rust Journal: Cancer Causes Control Date: 2021-10-27 Impact factor: 2.506
Authors: Melissa Flores; John M Ruiz; Emily A Butler; David A Sbarra; David O Garcia; Lindsay Kohler; Tracy E Crane; Giselle Corbie-Smith; Viola Benavente; Candyce H Kroenke; Nazmus Saquib; Cynthia A Thomson Journal: Ann Behav Med Date: 2021-06-28