Therefore, our urologic oncology practice made for a convenient setting in which to study prostate cancer within this cohort. Research Article Open Access. The cancer specific parameters of this cohort are listed in Table 2. Table 3 lists the comparisons of the Vietnamese American patients to patients at the University hospital. The question becomes whether this difference is due to the lack of regular screening and consequently a delay in diagnosis, environmental factors, or genetic causes. Eighteen percent of this cohort underwent radical prostatectomy as the initial treatment approach whereas approximately half opted for radiation therapy.
The medical charts of these patients were retrieved and reviewed by trained research associates.
The pathologic grade was obtained from the pathologist grading of prostate biopsy data using the Gleason grading system. Approximately half of the men had palpable disease on digital rectal examination at the time of presentation and half had Gleason 8 or higher prostate cancer.
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There were statistically ificant differences in the PSA levels and the percentage of patients with high grade disease, with Vietnamese American patients having higher PSAs and more frequently high grade disease. In contrast, in a contemporaneous group of patients from the university hospital with which we are affiliated, the median PSA was 6. Until recently, the data on prostate cancer screening among Asian Americans has been unpublished.
Their baseline demographics are listed in Table 1.
Further study is needed to evaluate the causes of these disparities. It is also the second leading cause of cancer mortality and s for 32, deaths per year [ 1 ]. However, we feel that these data are important because they highlight disparities in the clinical features of prostate cancer in these patients compared to other ethnic groups, and that these disparities may translate into worse outcomes.
We report our experience with prostate cancer among Vietnamese American men over the last decade.
Further study is needed to evaluate the long term outcomes in these patients, to determine the causes of these disparities, and to better understand factors responsible for decreased rates of prostate cancer screening in this population. Although some have questioned the effectiveness of prostate cancer screening, this cohort may be a case study on the importance of screening should we find high rates of biochemical recurrence, metastases, and cancer specific mortality with longer follow up. After institutional review board approval, we retrospectively reviewed our internal cancer registry for all Vietnamese American men who were diagnosed with prostate cancer from This subgroup was then extracted and cross referenced with our pathology database to confirm the diagnosis of prostate cancer.
Because of the relative lack of prostate cancer screening within the Vietnamese American community, we sought to characterize the clinical behavior of this cancer in Vietnamese American men. Although only 1 person from this cohort has died from his disease, our follow up period has been too short to characterize the rate of biochemical recurrence or progression to metastatic disease. Vietnamese Americans make up a ificant proportion of the patients we serve.
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Conclusions: Vietnamese American men with prostate cancer present with adverse features including higher PSA levels, higher clinical stages, and higher pathologic grades. Vietnamese Americans make up a ificant portion of this group, ing for 1. Analysis of the SEER database has shown that the incidence of prostate cancer among Asian Americans is approximately half that of Caucasians However, data from the California Cancer Registry showed that Asians often presented with worse prognostic factors [ 3 ].
Indeed, disparities in cancer screening for Asian Americans have been established for colorectal, cervical, and breast cancers [ 4 ]. : We identified 46 Vietnamese American men treated at our institution between The mean age at diagnosis is The median PSA was Approximately half had palpable disease on digital rectal examination at the time of presentation and half had Gleason 8 or higher prostate cancer.
Since the end of the Vietnam War, immigrants from Vietnam have emigrated to and settled in large communities in California, Texas, and Louisiana. Pathologic stage was determined by the clinical stage in vietnamese Valley AL dating who did not undergo surgery or pathologic stage in patients who did using the TNM system. Anti Spam Code: Can't read the image? While many studies have examined differences in the natural history and biology of prostate cancer among minority groups, relatively few have focused on Asian Americans and, in particular, Vietnamese Americans.
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Our cohort had some clinical features that are associated with worse outcomes as shown in Table 3. The PSA density was also relatively high at 1. The outcome variables studied were PSA level, pathologic grade, and clinical stage. Table 2: Cancer specific parameters of this cohort of Vietnamese men with prostate cancer.
Article Usage. Only time will tell whether these patients do poorly compared to other groups. This may be due to a lack of prostate cancer screening, genetic differences, or environmental factors.
Vietnamese-american men with prostate cancer present with worse clinicopathologic features compared to the general population
Post your comment. This observation may partially be explained by differences in cancer screening practices in this community. On the other hand, the Vietnamese cohort had worse clinical and pathologic features. In California, they for 1.
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Recommended Journals. We studied the clinical and pathologic features of prostate cancer in Vietnamese American men. Article Tools.
Purpose: Large epidemiologic studies have suggested racial differences in the behavior of prostate cancer in Asian Americans subgroups. The mean age at the time of diagnosis was The median PSA in this cohort was The mean follow was approximately 43 months. Vietnamese Valley AL dating Clara Valley Medical Center is funded and operated by the County of Santa Clara and serves uninsured and underinsured patients in the county. Incident cases are ascertained through hospital discharge summaries, clinic documentation, and pathologic diagnoses from biopsy or surgical specimen.
The median PSA, for instance, was Additionally, more than half of our patients had clinical T2 or higher disease on presentation and half had Gleason 8 or higher prostate cancer. These effects were independent of race. In their multivariate models, higher levels of education, income, and access to care were positively associated with having undergone prostate cancer screening. Despite the adverse features within this cohort including a median PSA greater than 10 and a greater proportion of patients presenting with higher clinical T stage and higher grade cancers, only one of these patients progressed to metastatic disease during the follow period and subsequently died.
International Conferences J Community Med Health Educ This is an open-access article distributed under the terms of the Creative Commons Attributionwhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Our a priori hypothesis was that the relative under-utilization of prostate cancer screening within this community may lead to delays in diagnosis, worse clinical and pathologic features at the time of diagnosis, and potentially worse oncologic outcomes.
It will be interesting to see how these patients do with another 5 years of follow up and if the aggressive features which with they presented result in poorer outcomes compared to other groups. Share This Article. Nevertheless, these should be interpreted with caution in attempting to generalize the findings to populations outside our geographic region. Guidelines Upcoming Special Issues. There are several weaknesses in this study including its retrospective nature, the short follow up period, and the relatively small of patients.
Vietnamese American men with prostate cancer present with adverse features including higher PSA levels, higher clinical stages, and higher pathologic grades when compared with other Asian American groups and the general population. Methods: We retrospectively reviewed our last decade of experience with prostate in Vietnamese American men and compared their baseline demographics and clinical and pathologic outcomes with Asian Americans in general and with a typical university hospital cohort.
Median age, yrs IQR Select your language of interest to view the total content in your interested language. These incident cases are filed in an internal cancer registry from which the are periodically reported. Like us on:. This relatively short follow up occurred because of patients lost in follow up due to changes in insurance status.