到 2022 年，美国将有超过 2000 万人被认定为亚裔美国人、夏威夷原住民或太平洋岛民 (AANHPI)。尽管 AANHPI 社区内的移民历史、生活经历和健康需求存在差异，但之前关于宫颈癌的研究已经考虑到我们试图分析美国宫颈癌分期的差异，重点关注分类的 AANHPI 群体。对 2004 年至 2020 年美国国家癌症数据库中 122,926 名新诊断宫颈癌患者的数据进行了回顾性分析。 AANHPI 患者按原籍国分类。根据临床和社会人口统计学因素调整后的逻辑回归用于计算调整后的比值比。较高的调整比值比表明诊断时发生转移性疾病与非转移性疾病的可能性增加。在 122,926 名宫颈癌患者中，5,142 名 (4.2%) 被确定为 AANHPI。与非西班牙裔白人 (NHW) 患者相比，合并的 AANHPI 患者处于较低的癌症分期（NHW：58.7% 诊断为本地/区域，AANHPI：85.6% 诊断为本地/区域，χ2 P<0.001）。最大的 AANHPI 亚群包括菲律宾裔美国人（n=1051，占 AANHPI 的 20.4%）、华裔美国人（n=995，占 19.4%）、亚裔印度/巴基斯坦裔美国人（n=711，占 13.8%）、越南裔美国人（n=627、 12.2%）和韩裔美国人（n=550, 10.7%）。 AANHPI 分类显示，相对于非西班牙裔白人患者，太平洋岛民美国患者出现转移性疾病的几率更高（aOR 1.58，95% CI 1.21-2.06，p = 0.001）。相反，华裔美国人（aOR 0.47，95% CI 0.37-0.59，p < 0.001）、越南裔美国人（aOR 0.54，95% CI 0.41-0.70，p < 0.001）、苗族美国人（aOR 0.46，95% CI 0.22-0.97） ，p = 0.040）和印度/巴基斯坦裔美国人（aOR 0.76，95% CI 0.61-0.94，p = 0.013）患者出现转移性疾病的可能性较小。与最大的 AANHPI 组（美籍华人）相比，其他 9 个亚组更有可能出现转移性疾病。差异最大的是美国太平洋岛民 (aOR 3.44, 95% CI 2.41-4.91, p < 0.001)、泰国裔美国人 (aOR 2.79, 95% CI 1.41-5.53, p = 0.003)、柬埔寨裔美国人 (aOR 2.39, 95) % CI 1.29-4.42，p = 0.006）、夏威夷原住民（aOR 2.23，95% CI 1.37-3.63，p = 0.001）和老挝裔美国人（aOR 2.02，95% CI 1.13-3.61，p = 0.017）。相比之下，越南裔美国人（aOR 1.20，95% CI 0.85-1.71，p = 0.303）和苗族美国人（aOR 1.09，95% CI 0.50-2.37，p = 0.828）患者在出现转移性肿瘤方面没有表现出统计学上的显着差异。对亚裔美国人、夏威夷原住民或太平洋岛民的综合评估掩盖了面临公平差距风险的不同人群的结果差异。这项分类研究表明，较大的 AANHPI 人群中的边缘群体（包括太平洋岛民美国人和泰裔美国人患者）可能面临不同的暴露以及癌症筛查和早期诊断的更大结构性障碍。未来有必要关注基于社区的分类研究和量身定制的干预措施，以弥补这些差距。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Over 20 million people in the United States identified as Asian American, Native Hawaiian, or Pacific Islander (AANHPI) in 2022. Despite the diversity of immigration histories, lived experiences, and health needs within the AANHPI community, prior studies in cervical cancer have considered this group in aggregate.We sought to analyze disparities in cervical cancer stage at presentation in the United States, focusing on disaggregated AANHPI groups.Data from the United States National Cancer Database from 2004 to 2020 of 122,926 patients newly diagnosed with cervical cancer was retrospectively analyzed. AANHPI patients were disaggregated by country of origin. Logistic regression, adjusted for clinical and sociodemographic factors, was used to calculate adjusted odds ratios. Higher adjusted odds ratios indicate an increased likelihood of metastatic versus non-metastatic disease at diagnosis.Out of 122,926 patients with cervical cancer, 5,142 (4.2%) identified as AANHPI. Compared to non-Hispanic White (NHW) patients, pooled AANHPI patients presented at lower stages of cancer (NHW: 58.7% diagnosed local/regional, AANHPI: 85.6% at local/regional, χ2 P<0.001). The largest AANHPI subgroups included Filipino Americans (n=1051, 20.4% of AANHPI), Chinese Americans (n=995, 19.4%), Asian Indian/Pakistani Americans (n=711, 13.8%), Vietnamese Americans (n=627, 12.2%), and Korean Americans (n=550, 10.7%) respectively. AANHPI disaggregation revealed that Pacific Islander American patients had higher odds of presenting with metastatic disease (aOR 1.58, 95% CI 1.21-2.06, p = 0.001) relative to non-Hispanic White patients. Conversely, Chinese American (aOR 0.47, 95% CI 0.37-0.59, p < 0.001), Vietnamese American (aOR 0.54, 95% CI 0.41-0.70, p < 0.001), Hmong American (aOR 0.46, 95% CI 0.22-0.97, p = 0.040), and Indian/Pakistani American (aOR 0.76, 95% CI 0.61-0.94, p = 0.013) patients were less likely to present with metastatic disease. Compared to the largest AANHPI group (Chinese American), nine other subgroups were more likely to present with metastatic disease. The largest differences were observed in Pacific Islander American (aOR 3.44, 95% CI 2.41-4.91, p < 0.001), Thai American (aOR 2.79, 95% CI 1.41-5.53, p = 0.003), Kampuchean American (aOR 2.39, 95% CI 1.29-4.42, p = 0.006), Native Hawaiian American (aOR 2.23, 95% CI 1.37-3.63, p = 0.001), and Laotian American (aOR 2.02, 95% CI 1.13-3.61, p = 0.017). In contrast, Vietnamese American (aOR 1.20, 95% CI 0.85-1.71, p = 0.303) and Hmong American (aOR 1.09, 95% CI 0.50-2.37, p = 0.828) patients did not show a statistically significant difference in presenting with metastatic disease compared to Chinese American patients.Aggregated evaluation of the Asian American, Native Hawaiian, or Pacific Islander monolith masks disparities in outcomes for distinct populations at risk for equity gaps. This disaggregation study shows that marginalized groups within the larger AANHPI population - including Pacific Islander American and Thai American patients - may face different exposures and larger structural barriers to cancer screening and early-stage diagnosis. A future focus on community based disaggregated research and tailored interventions is necessary to close these gaps.Copyright © 2024 Elsevier Inc. All rights reserved.