Disparities in Cancer and Cardiovascular Disease Mortality Among Asian Americans Diagnosed with Urologic Cancer

Background: Asian Americans (AA) in the United States represent a heterogenous population from various ethnic backgrounds. We compared cancer and cardiovascular disease (CVD) mortality between various AA groups and Non-Hispanic White (NHW) patients diagnosed with urologic cancer. Methods: We assembled a population-based cohort that included 389,114 prostate cancer, 98,721 renal cell cancer, and 126,485 bladder cancer patients. Cumulative cancer and CVD mortality were compared between AA and NHW groups, accounting for competing risk of death. Multivariable Cox models were used to quantify the cause-specific hazard ratio (HR) with a 95% confidence interval (CI), comparing AA subgroups (Chinese, Japanese, Korean, Filipino, Vietnamese, Other Southeast Asian, and Indian/Pakistani) to NHW patients. Results: AA ethnic subgroups had a lower or comparable mortality from prostate cancer compared with NHW patients (HR ranged 0.51–1.03). No overall difference was observed for renal cell cancer death, but an increased mortality was observed for Filipino (HR = 1.10; 95% CI, 1.00–1.22) and Other Southeast Asian (HR = 1.50; 95% CI, 1.06–2.12) patients that included Laotian, Hmong, Kampuchean, and Thai ethnicity. Although reduced mortality from bladder cancer (HR = 0.88; 95% CI, 0.83–0.93) was observed compared to NHW patients, an increased mortality was seen among Other Southeast Asians (HR = 1.63; 95% CI, 1.15–2.30). CVD mortality varied across AA ethnicities, with higher mortality observed in Filipino and Other Southeast Asian (HR ranged 1.23–2.40) compared with Chinese patients. Conclusions: Large heterogeneity exists in mortality among AA patients diagnosed with urologic cancer, with higher mortality from cancer and CVD observed in Filipino and Other Southeast Asian patients.