Cancer Education

Asian American Cancer Health Disparities

Who are Asian Americans?

According to the United States Office of Management and Budget (OMB) "Asians” refers to a person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
 

What health disparities affect Asian Americans?

Research has shown that cancer does not affect every population group equally. Below we have listed some findings related to cancer in the Asian American population. These findings helped document the "unequal burden" of cancer incidence and mortality that is carried by the Asian American population. The recognition of the need to reduce this "burden" led to the creation of AANCART.
 
  • 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).
     
  • Among Asian Americans, colorectal cancer is the second most common diagnosed cancer, and it is the third highest cause of cancer-related mortality (2).
     
  • Chinese have the highest mortality rates for lung and bronchial cancer among all Asian subgroups (3).
     
  • Filipinos have the highest rate for prostate cancer and thyroid cancer among all Asian subgroups.  However mortality rates for female breast cancer, prostate cancer, and thyroid cancer were the highest (3). 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).
     
  • Japanese have the highest incidence rates for colorectal cancer, female breast cancer, and uterine cancer among all Asian subgroups.  Japanese also have the highest mortality rates for colorectal cancer and uterine cancer (3).
     
  • Koreans have the highest incidence and mortality rates of stomach cancer among all Asian subgroups (3) a five-fold increased rate of stomach cancer over White American men (6).  Koreans have the lowest rate of colorectal cancer screening (2).
     
  • Vietnamese have the highest rates of liver cancer and for lung and bronchial cancers among all Asian subgroups. Liver cancer mortality rate is also the highest in this group (3).
     
  • 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). 
     
  • Hmong have elevated rates for hepatic, gastric, cervical, and nasopharyngeal cancers and for leukemia and non-Hodgkin lymphoma.  Rates of gastric cancer, cervical cancer, and lung cancer increased between 1988-2000.  Hmong experience later disease stage at diagnosis (4).
     
  • 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). 
     
  • 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, compared to Latino and African-American stores, 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. Wong ST, Gildengorin G, Nguyen TT, et al., Disparities in colorectal cancer screening rates among Asian Americans and Non-Latino Whites. Cancer 2005; 104 (12): S2940-S2947.

3. Kwong SL, Chen MS, Snipes KP, et al., Asian subgroups and cancer incidence and mortality rates in California. Cancer 2005; 104 (12): S2975-S2981.

4. Mills PK, Yang RC, Riordan D, Cancer incidence in the Hmong in California, 1988-2000. Cancer 2005; 104 (12): S2969-S2974.

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.