APAMSA | Resources | The Unequal Burden of Cancer Among Asian Americans

The Unequal Burden of Cancer Among Asian Americans

While heart disease is the leading cause of death for all U.S. groups (all ages), cancer has been the number one killer of Asian-American women since 1980 (1).
Asian-Americans/Pacific Islander (AAPI) women are the only U.S. population group that experienced an overall increase in cancer mortality for all cancers combined between 1990 and 1995 (2).
Between 1980 and 1993, the cancer death rate for AAPI women increased by 240%, and the rate for men increased by 290% -- the highest for all ethnic/racial groups (2).
The top cancer sites in All Americans are 1) Lung, 2) Colon/Rectum, 3) Breast, and 4) Prostate. However, in Asian Americans, Liver cancer is the third highest cancer site and Stomach Cancer is the fourth highest cancer site. (3-4).
The average annual percent change in prostate cancer for AAPI men increased 1.4% between 1990 and 1995. During the same period, the average annual percent change in prostate cancer for White American men decreased by 2.3% (2).
Lung cancer rates among Southeast Asians are 18% higher than among White Americans (5).
Cervical cancer incidence rates in Vietnamese women are five times higher than the rate among White American women (6).
Cervical cancer is the number one cancer to occur in Vietnamese women, whereas lung cancer is the most common cancer for all racial and ethnic groups (including AAPI women) (6).
Vietnamese men have the highest rates of liver cancer for all racial/ethnic groups (6).
The incidence of liver cancer in Chinese, Filipino, Japanese, Korean, and Vietnamese populations are 1.7 to 11.3 times higher than rates among White Americans (6).
Korean men experience the highest rate of stomach cancer of all racial/ethnic groups, and a five-fold increased rate of stomach cancer over White American men (6).
Filipinos have the second poorest five-year survival rates for colon and rectal cancers of all U.S. ethnic groups (second to American Indians) (7).
Significant variations are seen in smoking prevalence among AAPI populations. Markedly higher smoking rates are seen among Southeast Asian populations than among other Asian groups. Smoking rates are significantly higher among AAPI men than among AAPI women, regardless of country of origin (8).
Studies have found a higher density of tobacco billboards and store displays in Asian neighborhoods of many U.S. cities. In San Diego, California, the highest number of tobacco displays are found in Asian American stores (6.4/store), compared to Latino (4.6) and African-American stores (3.7), with the lowest number of store displays found in San Diego's White neighborhoods (9).

References

1. National Center for Health Statistics. Health, United States, 1998 With Socioeconomic Status and Health Chartbook. Hyattsville, MD, 1998.

2. National Center for Health Statistics. Health, United States, 1995. Hyattsville, MD: Public Health Service, 1996.

3. Parker SL, T Tong, S Bolded, PA Wingo. Cancer Statistics, 1997. CA 47: 5-27, 1997.

4. Parkin D, Whelan S, Ferlay J, Raymond L, Young J. Cancer Incidence in Five Continents. IACR Publication No. 143. Lyon: International Agency for Research on Cancer, 1997.

5. Coultas DB, Gong H Jr., Grad Reuben et al. State of the art: respiratory diseases in minorities of the United States. Am J Respir Crit Care Med 1994; 149: S93-S131.

6. Miller BA, LN Kolonel, L Bernstein, JL Young Jr. Racial/ethnic patterns of cancer in the United States 1988-1992. Bethesda, MD: National Cancer Institute, 1996. [NIH Publication No. 96-4104.]

7. Cooper GS, Yuan Z, Rimm AA. Racial Disparity in the incidence and case-fatality of colorectal cancer: analysis of 329 United States counties. Cancer Epidemiology Biomarkers Prev 1997; 6(4): 283-5.

8. U.S. Department of Health & Human Services. Tobacco use among U.S. racial ethnic minority groups: African American, Mexican Indians and Alaskan Natives, Asian American and Pacific Islanders, and Hispanics: A Report of the Surgeon General. Atlanta: Centers for Disease Prevention and Control, Office on Smoking and Health, 1998.

9. Elder JP, Edwards C, Conway TL. Independent evaluation of Proposition 99-funded efforts to prevent and control tobacco use in California. Sacramento: California Department of Health, 1993.

Compiled by: Andrew Hsu, Univ. of Texas Health Science Center at San Antonio SOM, National Education Officer 2005-2006