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Cancer Hits US Asian Groups Differently
Statistics Show Wide Variations Among 5 Main Ethnic Groups
Article date: 2007/07/11

Cancer affects Asian Americans in different ways than it does other racial
and ethnic groups in the US. A new American Cancer Society report provides
details of cancer patterns in this population -- and shows great
variations based on country of origin.

The report, published in the ACS journal CA: A Cancer Journal for
Clinicians, is one of the most thorough evaluations of cancer in Asian
Americans, according to the researchers. The authors say it can be used to
help tailor cancer prevention and early detection strategies for various
Asian groups in the US.

Overall, Asian Americans have the lowest cancer incidence and death rates
when compared to non-Hispanic whites, African Americans, and Hispanics in
the US. However, cancer is the leading cause of death among Asian
Americans, with heart disease being first among the other groups.

To better understand how cancer affects people of Asian descent living in
the US, the researchers used data from California. That state has the
greatest number of Asian Americans living in it -- about 3.7 million --
and uses a detailed breakdown of Asian ethnicity when collecting
population information. The researchers examined cancer trends in the 5
largest Asian-American groups: Chinese, Filipino, Vietnamese, Korean, and
Japanese.
Colorectal, Lung, and Liver Cancer Common in Chinese

Colorectal cancer rates are higher among Chinese Americans than most other
Asian groups, the report says, approaching that of non-Hispanic whites.
While the risk for this type of cancer is low in China, it is higher among
Chinese who have been in the US longer, hinting that adopting a Western
lifestyle may play a role.

Chinese Americans are more likely than other Asian groups to be screened
for colorectal cancer. Still, only about 40% of men and 42% of women
report having a colonoscopy in the past 5 years.

Liver cancer also takes a high toll among Chinese-American men. This
cancer is also very common in China itself, and may be caused in part by
high rates of infection with the hepatitis B virus in that country.

Lung cancer rates are high among Chinese-American women, the report says,
which is surprising because comparatively few Chinese-American women
smoke. However, many are exposed to secondhand smoke at home and at work,
as well as to smoke from high-temperature frying.
Prostate, Breast Cancer Plague Filipinos

Prostate cancer is the most commonly diagnosed cancer among Asian-American
men of all ethnicities, and Filipino men have the highest incidence and
death rates from this cancer of all Asian-American groups.

Lung cancer is also a problem among Filipino men. They have the
second-highest incidence rate and the highest death rate from this
disease.

Filipino women have the highest breast cancer death rate and the
second-highest breast cancer incidence rate of Asian-American women. One
factor that may contribute to this is the percentage of overweight women
in the Filipino community, which is the highest of all the ethnic groups
studied. Being overweight or obese is a well-established risk factor for
breast cancer after menopause.

Liver, Stomach, Cervical Cancer Common in Vietnamese

Vietnamese men have the highest incidence and death rates of liver cancer
of all Asian-American groups studied. Liver cancer is very common in
Vietnam, where chronic infection with the hepatitis B virus is widespread.
Because many Vietnamese in the US are recent immigrants, they may be more
likely to have this risk factor for liver cancer, the report says.

Vietnamese women have the highest incidence and death rates for cervical
cancer of all Asian groups studied. Screening for cervical cancer with a
Pap test is less common among Vietnamese women than it is among several
other Asian groups. About 70% reported getting a Pap test within the past
3 years.

Lung cancer is more common among Vietnamese men and women than it is among
the other Asian groups included in the report. Stomach cancer is also
common among both men and women of Vietnamese descent.
Stomach Cancer a Concern Among Koreans

Stomach cancer is much more common among people of Korean ancestry than
other Asian groups, and death rates from this disease are highest among
Koreans. The typical Korean diet, which includes many foods that are high
in salt and nitrates/nitrites, may be part of the reason stomach cancer
rates are so high.

Koreans also have the highest rates of liver cancer among women and the
second highest rate among men. This is likely caused by the high
prevalence of hepatitis B virus infection in the Korean population, the
report says.

Korean women have the lowest screening rate for cervical cancer, and the
second highest incidence and death rate from that disease.

Colorectal cancer screening rates are also low among Korean Americans;
Korean-American men have the second-highest colorectal cancer incidence
and death rates.

Lung cancer is not as common among Korean men as it is among some other
Asian men, but Korean men have the highest death rate from the disease.

Colorectal, Breast Cancers High Among Japanese

Japanese men and women have the highest rate of colorectal cancers and
deaths of all Asian groups. One reason may be that the Japanese are more
likely to be overweight than members of most other Asian groups, and being
overweight raises a person's risk of developing colorectal cancer. In
addition, a large percentage of Japanese men do not meet physical activity
guidelines, another factor that can raise colon cancer risk.

Japanese women have the highest incidence of breast cancer among the Asian
Americans included in the report. However, Japanese women also have the
highest breast cancer screening rates, which may mean cancers are simply
more likely to be detected in Japanese women than other groups.

Stomach cancer also takes a large toll in the Japanese community. A diet
high in salt and nitrates/nitrites may be partly responsible.

Language-Specific Cancer Materials Available

Language barriers are one of the problems facing many Asian Americans
dealing with cancer, particularly those who came to the US recently. The
report highlights some resources to help overcome these obstacles.

ACS has worked with the Asian American Network for Cancer Awareness,
Research and Training (AANCART) to develop a searchable Web site with
materials on cancer prevention and early detection in more than 12 Asian
and Pacific Islander languages.

The report also urges doctors to familiarize themselves with the cancers
that are more common in Asian populations than in other US ethnic/racial
groups.

Citation: " Cancer Incidence, Mortality, and Associated Risk Factors Among
Asian Americans of Chinese, Filipino, Vietnamese, Korean, and Japanese
Ethnicities." Published in the July/August 2007 CA: A Cancer Journal for
Clinicians (Vol. 57, No. 4: 190-205). First author: Melissa McCracken,
MPH, American Cancer Society.