Differences in Cancer Rates Seen Among Asian American and Native Hawaiian/Pacific Islander Populations

Significant differences in cancer rates were found between Asian Americans and Native Hawaiians/Pacific Islanders (AANHPIs), according to a special report within Cancer Facts & Figures 2016, which also appeared in CA: A Cancer Journal for Clinicians (doi:10.3322/caac.21335). These differences in cancer burden reflect the vast differences in cancer risk factors.

Among the total US population, Asian Americans comprise 6.3% (20 million of 318.7 million), and they are the fastest growing racial/ethnic group in the United States. In addition, Native Hawaiians and Pacific Islanders are one of the fastest-growing US populations, comprising 1.5 million people. Cancer rates are generally higher among Native Hawaiians and Pacific Islanders than among Asian Americans.

In this report, the term Asian indicates a person with origins in the Far East, Southeast Asia, or the Indian subcontinent, with the group including, but not limited to, Asian Indians, Cambodians, Chinese, Filipinos, Hmong, Japanese, Koreans, Pakistanis, and Vietnamese. The term Native Hawaiian and Pacific Islander (NHPI) refers to people with origins in Hawaii, Guam, Samoa, or other Pacific Islands.

Notably, cancer rates within these groups vary widely. Because of differences in smoking, lung cancer rates in Samoan men (98.9 per 100,000) are approximately 30% higher than rates in Hawaiian (72.1), non-Hispanic white (NHW) (71.2), and Laotian (65.2) men and almost 80% higher than in Asian Indian/Pakistani men (21.1).

Similarly, liver cancer rates vary: rates in Laotian (66.1 per 100,000) and Vietnamese (51.9) men are 2 to 4 times higher than those in Chinese (21.7), Koreans (26), and Filipinos (16.7), and almost 10 times higher than Asian Indians and Pakistanis (6.5), who have the lowest rates.

Overall incidence rates per 100,000 males during 2006 to 2011 range from 216.8 among Asian Indians/Pakistanis to 526.5 among Samoans, whose rates are similar to rates in non-Hispanic whites (554.1). Per 100,000 females, rates range from 212.0 among Asian Indians/Pakistanis to 442.8 among Samoans, also similar to rates in non-Hispanic whites (444.6). For both genders, Samoans had the highest cancer incidence rates, followed by Native Hawaiians and Japanese.

Chinese women had relatively high rates of lung cancer, despite the low prevalence of smoking in this group, and that may be due to exposure to cooking oils at high heat, secondhand smoke, genetic susceptibility, or other unknown risk factors.

Within the past 3 years, use of the Pap test was highest among Filipino women (83%, same as non-Hispanic whites) and lowest among Chinese women (66%). Increased screening and treatment of precancerous lesions among Cambodian, Vietnamese, and Laotian women is credited with dramatic decreases in incidence rates of cervical cancer from 1990 to 2008.

"The variations we see in cancer rates in AANHPIs are related to risk factors, including lifestyle factors, use of screening and preventive services, and exposure to cancer-causing infections," said Lindsey Torre, MSPH, of the American Cancer Society, in Atlanta, Georgia, and corresponding author of the study.

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