Introduction
Breast cancer is known as the most commonly diagnosed disease among women. It is not restricted to a single cast race or ethnicity. As compared to white women Asian women suffering from breast cancer are diagnosed at the later stages of the disease, and they also have higher death rates. Many studies are dot done on the racial differences experienced by the survival during the treatment or during diagnosis. Disparities in the breast cancer survival women could be due to inequality in the screening of breast cancer, its diagnosis, treatment and follow-up after the treatment. Research shows that how patients with breast cancer cope and go through depression, emotional distress, psychological problems. Certain studies also promote social support, the physical and emotional well-being of the breast cancer patient. These strategies are different in Asian and non-Asian women around the globe. In the Asian women residing in the United States the incidence of breast cancer in different within the ethnic population.
The results of different studies and researches were different for the various ethnic groups. For instance, it was reported in a study which was population based, that the late-stage survival rate of patients was very less in the women of Filipino as compared to the women who are African American, and it was also reported that the survival rate of Japanese women was more constructive than non-Hispanic White women. Which Identity and explain that these differences are vital for public health to remove disproportion in results after any disease such as breast cancer. Though justifications for the cultural dissimilarity in survival patients of breast cancer in the women of Asia have not yet deeply studied beside from the socio-demographic factors, effects of disparities in the treatment, characteristics of the tumor.
The Asian populations living in the United States are mixed on immigration and acculturation; different factors serve to explain different effects. Still, the trials that examine the effects of such factors are held back through the gaps and differences in the study which are based on population. Approximately the 25% breast cancer patients who presented at National Cancer Institute's have missing data of their birthplace. To continue the trial to minimize disparities of breast cancer in the Asian women, an advanced population-based study registered in the data of cancer registry to facilitate the assessment of the effects of personal and neighborhood stage aspects with survival after the diagnosis of breast cancer in the Asians. Which include the women who are Chinese, Filipina, Korean, Japanese, Vietnamese, and South Asian, in the California.
The data was enhanced in 2 way by firstly using novel methods throughout Social Security number (SSN) for using the data of the immigrants by their age at the assignment to select nativity about the record which was incorrect or missing. Secondly, they connected the data from the registry with the U.S. Census records to include neighborhood features showing Asian ethnic enclave and SES in the analyses. A neighborhood level of the ethnic cooperative was designed as the geographical element with a larger focus on the Asian speakers and Asian population than further units in the city California. Therefore, in this paper it will be critically analyzed that among this improved registry record, if the individual level status of immigrants, socioeconomic status (SES) and the neighborhood level ethnic enclave explained disparities between breast cancer survivor after the analysis between groups of Asian ethnic and across it (Swift, 2002).
Methods
In California, those Asian women who were diagnosed in early stages of breast cancer during 1st January 1988 and 31st December 2005 got eligible for this analysis. The data from the Cancer Registry of California was also included in the Epidemiology, Surveillance, also the programs of the End Results. In this registry, they collect data on a regular basis about gender, age, race, the severity of the disease, ethnicity, and modalities of treatment for the initial four months after the diagnosis of breast cancer. The registry also contains follow-up data, records of the death, and other records. Information from the Cancer Registry of California was accessible for particularly classifying patients of cancer such as Filipino, Chinese, Filipino, Korean, Japanese, and South Asians (Pakistani, Asian Indian, Bangladeshi or Sri Lankan). They all were grouped together and represented all Asian approximately 93% residing in California Patients of breast cancer are registered in the records of the registry as the Asian, not otherwise specified approximately 5% patients, for 55%. They were capable of registering a much more accurate population of Asian ethnic from the place of birth and names through relating North American Association of Central Cancer Registries of the Asian.
Using algorithm considerably advances the formerly registered reasonable misclassification of the women of Asians in the registry of cancer because they previously declared that misclassification takes place when people are termed as Asian, not much precise. Following the elimination of the women of Asia, not in one of the six groups of ethnic, diagnosis at the time of death (n = 47), or patients whose data were missing and incorrect time of survival (n = 5). Patients with breast cancer whose residence might not be correctly recorded at the diagnosis to a group block survey or allocated a neighborhood value (n = 232), records of data for 20 747 suffering patients were accessible for the analysis (Gomez, Shema, Chang, Keegan, & Glaser, 2010).
Immigrant’s status
Discussion
In the health sector, a large variety of disparities is seen in Asian women as compared to white ones depending upon the ethnic populations. The studies and researches which represented statistics on breast cancer screening, risk factors, incidence and the results disaggregated showed remarkable variation by the individual having Asian nationalities. But due to incomplete data studies are unable to detect the difference between acculturation and in immigrants. In the past, only one population-based study was conducted which evaluated the effects of immigrant status on breast cancer survival patients. In Epidemiology, Surveillance, and End Results Program record collected from Hawaii, San Francisco–Oakland, and Seattle–Puget Sound that eliminated cases with missing or incorrect birthplace information, Pineda et al. stated no disparity in survival rate after the disease by place of birth for Chinese, Japanese, and Filipina women. Studies conducted in healthy populations presented that, as compared to the US-born individuals, the foreign-born Asians shows a different profile for the breast cancer risk and outcomes. In the study, they formerly reported comparable data of breast cancer patients between foreign and US-born Japanese women.
The lifestyle of the Women in Japan has Westernized, and the population occurrence of breast cancer risk factors has increased extensively. Higher SES have distributed the risk factors of breast cancer as a result of a societal shift in this population the data, neighborhood SES and ethnic cooperative did not vary for foreign, and the US-born Japanese. It is because when Japanese women received SNN were younger in the chosen study and approximately 83% of them were less than 40 years, as compared to women from other ethnic groups (65% before age 40). It is expected that foreign-born Japanese women were the ones who immigrated earlier in their life and were more acculturated than the other foreign-born Asian women.
While critically analyzing these approaches it can be said that the use of Epidemiology, Surveillance, and the programs of the End Results is effective enough to find out the number of breast cancer patients. Furthermore, the use of algorithm is a best way to control the misclassification of the women of Asians in the registry of cancer. Moreover, it is also critically analyzed that the rate of breast cancer is widely spread and it can be found in various countries.
Statistical Analyses
The researchers computed forms with Asian ethnic women and groups of immigrants evaluate mortality rate of the Japanese born in the US, who were chosen for the trial as the reference group as they had the highest rates of survival among all the groups of Asian ethnic and huge size of the sample. Then they computed date that is specified through ethnicity models to evaluate the effects of the patient’s characteristics on breast cancer precise mortality within the Asian ethnic groups. They did not carry out multilevel analyses study because they found the smallest clustering of the cases of breast cancer in the survey block groups: the greater group had 1 (55%) or two (21%) of the cases. All the tests that were statistical were of 2-sided. Also, they conducted all analyses of the study with the SAS version 9.1.3 they did not present the values with lesser than cases which were 5 cases to protect the patients. Critically assessing the multilevel analyses it can be said that protection of patients from this disease is necessary and for that this SAS version 9.1.3 is not enough.
Result
The outcomes of the study were that all the US-born Asian women have similar fatality rates due to that the breast cancer rate is high. However, those who are exposed to lower mortality risk are Vietnamese women. It is noticed that the reference group the US-born Japanese women and all other foreign-born women have increased mortality than the local Japanese women of Japan. After the critical analyses of the HRs that is ranged from 1.4 (95%) among Koreans to 1.8 (95%) among South Asian women and Vietnamese women it can be said that the ratio of cancer is quit high. Little of this disparity was explained by differences in the characteristics of the disease.
Conclusion
It was concluded that the changes of survival in women after being diagnosed with breast cancer is low in foreign-born Asians than US-born Asians. Further researches and studies need to be conducted to evaluate primary factors and improve ways to increase the level of awareness and better controls to manage cancer.
References
Gomez, S. L., Quach, T., Horn-Ross, P. L., Pham, J. T., Cockburn, M., Chang, E. T., . . . Clarke, C. A. (2010). Hidden breast cancer disparities in Asian women: disaggregating incidence rates by ethnicity and migrant status. American Journal of Public Health, 100(S1), S125-S131.
http://www.ncbi.nlm.nih.gov/pubmed/?term=Hidden+breast+cancer+disparities+in+Asian+women%3A+disaggregating+incidence+rates+by+ethnicity+and+migrant+status
Gomez, S. L., Shema, S. J., Chang, E. T., Keegan, T. H., & Glaser, S. L. (2010). Disparities in breast cancer survival among Asian women by ethnicity and immigrant status: a population-based study. American Journal of Public Health, 100(5), 861-869.
www.ncbi.nlm.nih.gov/pubmed/202996
Swift, E. K. (2002). Guidance for the National Healthcare Disparities Report. Washington, D.C: National Academies Press.
https://books.google.com/books?id=8F-bAgAAQBAJ&pg=PA7&dq=Guidance+for+the+National+Healthcare+Disparities+Report&hl=en&sa=X&redir_esc=y#v=onepage&q=Guidance%20for%20the%20National%20Healthcare%20Disparities%20Report&f=false
