Survival of the Hmong population diagnosed with colorectal cancer in the United States.

152 Background: The Hmong people constitute an Asian-American subgroup, accounting for 0.1% of the United States (US) population. Originating from Laos and Vietnam, Hmong individuals fought as secret soldiers for the US during the Vietnam War and later immigrated to the US, with the largest settlements in Minnesota, Wisconsin, and California. The Hmong population has faced various health disparities in the domains of mental health, chronic disease, and cancer. This study seeks to investigate trends in colorectal cancer (CRC) survival in the US Hmong population. Methods: Cases of colon and rectal adenocarcinoma diagnosed between 2004-2017 were identified within the National Cancer Database. Summary statistics of demographic, clinical, socioeconomic, and treatment variables were calculated. Multiple Cox proportional hazard models were constructed using sets of demographic, clinical, socioeconomic, and treatment variables to identify factors associated with overall survival (OS) within the Hmong population diagnosed with CRC. Results: One hundred and twenty (0.01%) Hmong individuals were identified within a total of 881,243 CRC cases. Their average age at diagnosis was 58.9 years, compared 68.7 years for Non-Hispanic White (NHW) individuals (p < 0.01). Over half of Hmong individuals (52.5%) were diagnosed with Stage III or VI disease (NHW, 42.5%, p < 0.03), and they more frequently resided in the lowest median income quartile (p < 0.01), the lowest high school degree achievement quartile (p < 0.01), and had higher rates of Medicaid coverage (p < 0.01) compared to NHWs. When adjusting only for age, sex, stage, and Charlson-Deyo comorbidity score, Hmong individuals had a greater hazard of death compared to their NHW counterparts (HR 1.43, p < 0.01). However, in a multivariable model accounting for all variables suspected to be associated with CRC outcomes, OS was similar between these groups (HR 1.01, p < 0.93). Conclusions: Hmong individuals diagnosed with CRC appear to have similar overall survival to Non-Hispanic Whites despite belonging to lower socioeconomic groups, being diagnosed at a younger age and with a higher proportion of Stage III/VI disease. This may point to a robust response to treatment and resilience within the Hmong community. Future efforts will focus on disseminating this information and developing community-based approaches for health screening and prevention.