Abstract 7091: Disparities in non small cell lung cancer treatment and outcomes among Native Hawaiian and other Pacific Islander populations

Abstract Background: The American Cancer Society and National Cancer Institute, emphasize the critical need to disaggregate data for Asian, Native Hawaiian, and Other Pacific Islander (NHOPI) populations to better understand racial disparities in cancer. NHOPI populations are highly diverse, with distinct genetic, cultural, and socioeconomic backgrounds that can influence cancer outcomes. This study aims to analyze Native Hawaiian, and other Pacific Islander patients with non-small cell lung cancer (NSCLC) to identify disparities in prognostic factors, treatment, and outcomes. Methods: Data were abstracted from 4, 143 NSCLC patients treated at Queen's Medical Center in Honolulu, Hawaii, between 2000 and 2022. Patients were grouped by race: White, Asian, Native Hawaiian, and other Pacific Islander. Kaplan-Meier survival estimates, and Cox proportional hazards models were applied to adjust for demographic, clinical, and treatment-related factors. Results: Among the 4, 143 patients diagnosed with NSCLC, the racial distribution included 971 White patients, 2, 324 Asian patients, 637 Native Hawaiian (NH) patients, and 211 Pacific Islander (PI) patients. PI patients were generally younger, more likely to present with late-stage disease, and more often underinsured compared to other racial groups including Native Hawaiians. Median overall survival (OS) was 20.9 months for whites, 20.1 months for Asians, 15.8 months for NH, and 10.3 months for PI (p<0.001). Both NH and PI patients were less likely to undergo surgery despite having stage I disease (NH HR 0.52, 95% CI 0.33-0.84; PI HR 0.29, 95% CI 0.12-0.70). Additionally, PI patients less often received systemic therapy for advanced-stage disease (PI HR 0.56, 95% CI 0.38-0.81) compared to whites. In adjusted models without treatment, NH and PI patients exhibited worse survival compared to whites (NH HR 1.12, 95% CI 1.01-1.26; PI HR 1.16, 95% CI 0.97-1.39). However, when treatment was included in the model, these differences were no longer significant. Conclusion: Native Hawaiian (NH) and Pacific Islander (PI) patients with cancer should be studied independently due to their unique sociodemographic characteristics and treatment patterns. Both groups showed lower survival rates compared to whites, largely due to disparities in treatment. Citation Format: Chalothorn Wannaphut, Manasawee Tanariyakul, Jared Acoba. Disparities in non small cell lung cancer treatment and outcomes among Native Hawaiian and other Pacific Islander populations [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7091.