Asian Americans and Pacific Islanders (AAPIs) are the fastest growing ethnic population in the U.S. Often considered a 'model minority' with a level of health at least equivalent to that of Caucasians, there is, nonetheless evidence that AAPIs are at higher risk for cancer and its sequelae. However, little is known about the quality of cancer treatment AAPIs receive and how this treatment is related to patient outcomes.
Our specific aims are to: 1. Assess the quality of care delivered to patients with breast and colorectal cancer in Hawaii and determine if, for Chinese, Filipino, Hawaiian and Japanese individuals, this differs from state norms. 2. Examine overall and stage-stratified outcomes (i.e., stage-specific cancer recurrence and mortality) to determine if differences exist between AAPIs and Caucasians and if such differences related to treatment. 3. Use a linkage algorithm to anonymously, but specifically, link administrative clams data from Hawaii's largest insurer to the National Cancer Data Base, a national registry accessioning nearly 100% of Hawaii cases. Through this linkage, we will study the impact of comorbid, non-cancer conditions on stage-specific management and outcomes of patients with breast and colorectal cancer. 4. Assess the quality of current data collection mechanisms by specifically correlating information on cancer treatment obtained through traditional registry mechanisms with that obtained from insurer-provided administrative claims data. The proposed project will be conducted in 2 phases. First, using National Cancer Data Base data from the state of Hawaii, we will compare the patterns of care among Chinese, Filipino, Hawaiian, and Japanese patients with early breast cancer (Stages I and II) and more advanced colon (Stage III) and rectal (Stage II and III) cancer with the care received by Caucasians. Second, we will link this data to the administrative claims data from Hawaii Medical Service Association, Hawaii's largest insurer, to examine the impact of patient comorbidity and severity of illness on stage-specific management and outcomes and to examine the quality of NCDB data by comparing treatment information derived from this source with actual utilization based on administrative claims data.
