Abstract B141: Disparities in cancer survival among US-born and foreign-born populations by race and ethnicity

Abstract Purpose: Disparities in cancer survival are well-documented, yet the specific role of nativity status within different racial and ethnic groups is less understood. This study aims to examine disparities in survival after a cancer diagnosis based on the intersection of race/ethnicity and nativity among cancer survivors in the United States. Methods: We used pooled data from the 1997–2018 National Health Interview Survey, linked to the National Death Index with follow-up through December 31, 2019. The study population included participants who self-reported a cancer diagnosis in the survey baseline and were categorized into eight groups: US-born and foreign-born White, Black, Asian, and Hispanic individuals. Cox regression was used to estimate hazard ratios and 1-, 5-, and 10-year adjusted survival probabilities for all-cause and cancer mortality, controlling for sociodemographic, health status, and behavioral factors. All analyses were stratified by sex and conducted using Stata 18. Result: The study cohort included 53,881 adult cancer survivors (60.5% women) with a mean age of 64.4 years and a mean follow-up of 8.2 years. After full adjustment, significant disparities in survival were observed, with foreign-born individuals generally showing higher survival than their US-born counterparts within the same racial/ethnic group. For cancer survival, 10-year survival among women was highest for foreign-born Asians (95.58%) and lowest for US-born Blacks (92.57%). Among men, survival was highest for foreign-born Asians (92.36%) and lowest for foreign-born Whites (89.18%). For all-cause survival, foreign-born Asians had the highest 10-year survival for both women (91.43%) and men (88.86%), while survival was lowest for US-born Black women (88.05%) and US-born White men (80.48%). The largest intra-racial survival advantage for foreign-born individuals was seen among Asian men for all-cause survival (7.29%), while the narrowest was among White women (1.01%). The survival disparities between groups narrowed after adjustment, but significant differences persisted. Conclusion: Nativity is a crucial determinant of cancer survival, creating significant intra-racial disparities. While foreign-born individuals generally had higher all-cause survival, this advantage was not universal for cancer survival, with exceptions noted among White men and Hispanic women. The persistence of these complex, nativity-based disparities after full adjustment highlights the need for targeted interventions. Addressing these survival gaps is increasingly important for public health equity in a nation with a large and growing foreign-born population. Citation Format: Aminu K. Abubakar, Phuong T. Nguyen, Mahbubur Rahman. Disparities in cancer survival among US-born and foreign-born populations by race and ethnicity [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr B141.