Survival disparities among Asian, Native Hawaiian and Pacific Islander (ANHPI) patients with non-Hodgkin lymphoma (NHL) in the United States.

Background: Non-Hodgkin lymphoma (NHL) is the seventh most common cancer among Asian, Native Hawaiian and Pacific Islanders (ANHPIs), yet the risk of death in specific ANHPI subgroups in the US is unknown.

Methods: We used Surveillance, Epidemiology, and End Results data to investigate relative survival and the risk of death among NHL patients in ANHPI subgroups. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals (CI), comparing ANHPI subgroups to non-Hispanic White (NHW) NHL patients for all-cause death and NHL-specific death. Prognostic factors were further estimated within each ANHPI subgroup.

Results: We identified 4,513 East Asian, 4,034 Southeast Asian, 1,052 South Asian, 674 Native Hawaiian and Pacific Islander (NHPI), and 116,922 NHW patients with NHL. Compared to NHW patients, East Asian, Southeast Asian, and NHPI patients had a lower 5-year relative survival. The risk of 5-year all-cause death was 1.10-fold higher for East Asian patients (95% CI 1.04, 1.15), 1.34-fold higher for Southeast Asian patients (95% CI 1.27, 1.41), and 1.62-fold higher for NHPI patients (95% CI 1.43, 1.83) compared to NHW patients. Potential prognostic factors among ANHPI NHL patients included older age at cancer diagnosis, non-married status, advanced cancer stage, and a diagnosis of DLBCL or T-cell lymphoma.

Conclusion: Our study revealed significant disparities in survival among ANHPI patients with NHL, particularly among East Asian, Southeast Asian, and NHPI patients. Addressing these disparities calls for the implementation of preventive strategies and interventions tailored specifically to ANHPI subgroups. Further studies are imperative to explore adverse health outcomes within these ANHPI subgroups.