Survival Factors Found to Differ for Men and Women in the First study of Chinese Americans with Lung Cancer

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Cancer Prevention Institute of California new study finds longer survival for married women and those living in higher socioeconomic neighborhoods.

CPIC Research Scientist Scarlett Lin Gomez, Ph.D.

"Among Chinese Americans, rates of lung cancer have been either increasing or stable, depending on which histology you look at. And this is interesting because this is in contrast to patterns we see in other U.S. populations,” said Dr. Gomez.

In the first study of Chinese Americans with lung cancer, led by the Cancer Prevention Institute of California and published in the February issue of the Journal of Global Oncology, researchers found some key differences between men and women. A summary of the research findings is now available on the ASCO homepage and the ASCO Connection website.

These findings are relevant for the 4 million Chinese Americans living in the United States, the largest Asian group. Lung cancer is the second most common cancer among men and the fourth most common cancer among women. For both Chinese-American men and women, lung cancer is the most common cause of cancer deaths.

Chinese American women diagnosed with lung cancer lived, on average, 5.7 months longer than Chinese American men with the same diagnosis.

Married women lived 3.1 months longer than non-married women. Women who lived in the highest socioeconomic status (SES) neighborhoods lived a full 12.3 months longer than women who lived in lower-income neighborhoods. However, these social factors had less impact on the survival for men.

Neighborhood SES is a composite index comprised of U.S. Census data based on education, occupation, employment, household income, poverty, rent and house values.

According to the study’s lead researcher, Scarlett Lin Gomez, Ph.D., M.P.H., an epidemiologist at the Cancer Prevention Institute of California and the Stanford University School of Medicine, “Is this effect seen because women who are married have greater social support, mental support, or financial support? Is the driving factor here that some neighborhoods have greater access to certain economic and medical resources? The benefit of this kind of epidemiology is that we can uncover patterns that help us pinpoint areas where we might focus, whether for research or interventions. Once we are able to determine what the factors are that are driving these patterns, we can design targeted interventions that may improve the length and quality of survival, for Chinese Americans and other populations.”

Previous studies have also indicated that the better survival among women, regardless of race/ethnicity, may be related to differences in tumor molecular or biologic profile, drug metabolism, and/or DNA damage susceptibility and repair capacity.

For both men and women survival was longer for those treated at a National Cancer Institute (NCI) Cancer Center and varied by the type of lung cancer. The study found that men who were treated at NCI-designated centers lived an average of 22.4 months, whereas those treated at non-NCI centers lived for an average of 12.1 months. Chinese American women treated at NCI centers also lived significantly longer than Chinese American women not treated at NCI centers (34.2 months versus 17.6 months).

Dr. Gomez chose to focus her research on Chinese Americans diagnosed with lung cancer because of the population’s unique characteristics.

"First, among Chinese Americans, rates of lung cancer have been either increasing or stable, depending on which histology you look at. And this is interesting because this is in contrast to patterns we see in other U.S. populations,” said Dr. Gomez. "Second, lung cancer is the most common cause of death in the Chinese American population. Third, Chinese Americans tend to have unique molecular profiles such as epidermal growth factor receptor mutations, and among Chinese American females, there is a much, much higher proportion of those who have never smoked."

In this study, researchers looked to the population-based California Cancer Registry to find data on 1,616 women and 2,216 men who were diagnosed with lung cancer between 2000 and 2010.

Other collaborators on the study include Juan Yang of the Cancer Prevention Institute of California; Iona Cheng of the Cancer Prevention Institute of California and Stanford Cancer Institute; Christina A. Clarke of the Cancer Prevention Institute of California, Stanford Cancer Institute and Department of Health Research and Policy (Epidemiology), Stanford School of Medicine; Shih-Wen Lin, Margaret McCusker, and Alan Sandler of Genentech; Manali Patel and Heather A. Wakelee of the Stanford Cancer Institute.

About the Cancer Prevention Institute of California
The Cancer Prevention Institute of California is the nation’s premier organization dedicated to preventing cancer and to reducing its burden where it cannot yet be prevented. CPIC tracks patterns of cancer throughout the entire population and identifies those at risk for developing cancer. Its research scientists are leaders in investigating the causes of cancer in large populations to advance the development of prevention-focused interventions. CPIC’s innovative cancer prevention research and education programs, together with the work of the Stanford Cancer Institute, can make our vision of a world without cancer a reality. For more information, visit CPIC’s official website at http://www.cpic.org.

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