Clinical characteristics, treatment patterns, and outcomes of common solid tumors in Arab American patients.

Abstract

e23407 Background: Arab Americans are frequently misclassified as White in U.S. cancer registries, limiting the study of cancer presentation, treatment patterns, and outcomes in this understudied population. Michigan hosts the largest Arab American community in the U.S., providing an opportunity to characterize cancer epidemiology in this group. We aimed to describe clinicopathologic features, treatment patterns, and outcomes across solid tumors in an institutional Arab American cohort to support future disparities-focused investigations. Methods: We created a database by identifying patients with Arabic or Arab-appearing surnames and confirming Arab ethnicity through chart review based on self-reported language and/or country of origin. Patients with any solid tumor at any stage were included; those with unconfirmed or non-Arab origin were excluded. Demographics, tumor characteristics, treatments, and outcomes were collected. Treatment patterns were analyzed by cancer type and stage. Survival was assessed using Kaplan–Meier methods, with multivariable Cox regression performed to evaluate prognostic factors for overall survival. Results: A total of 96 patients were included (2004-2024): breast (n = 40), colorectal (n = 20), prostate (n = 20), and lung (n = 16) cancers. The median age was 56 years and 64.6% presented with early-stage disease (AJCC 8 th Edition, I–II). Surgery was performed in 68.8%, chemotherapy in 40.6%, radiation in 44.8%, hormone therapy in 40.6%, immunotherapy in 3.1%, and targeted therapy in 4.2%. There was significant overlap reflecting multimodality therapy in stage I–III disease, whereas stage IV patients were predominantly treated with systemic therapy alone (73.3%). At a median follow-up of 56 months, median OS was not reached (95% CI: 129 months to NR), with 5-year OS of 80.2% (95% CI: 71.8%–89.6%). Cancer-specific 5-year OS varied: breast 91.9%, prostate 93.3%, lung 59.6%, and colorectal 58.2%. Median PFS for all stages was 80 months (95% CI: 50-NR), with stage III–IV patients having median PFS of 13 months (95% CI: 9–45). In multivariable analysis, age < 65 years was associated with improved survival (HR 0.163, 95% CI: 0.038–0.705, p = 0.015), while advanced stage (III–IV) showed a trend toward worse outcomes (HR 3.374, 95% CI: 0.910–12.517, p = 0.069). Indirect comparison to SEER-published 5-year relative survival estimates revealed lower 5-year OS for colorectal cancer (58.2% vs ~65%) in our cohort, while breast, prostate, and lung cancer survival were similar or higher than population benchmarks. Conclusions: This is the first descriptive study to characterize treatment patterns and oncologic outcomes among Arab American patients. This preliminary analysis highlights the need for expanded comparative and molecular studies of site-specific cancers to better understand racial disparities in outcomes.