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Report: Wide variation in cancer rates in Asian American/Native Hawaiian/Pacific Islanders

A new report describes cancer among Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs), and reports striking variation in the cancer burden within this population, reflecting vast differences in exposure to cancer risk factors.

Lung cancer rates in Samoan men (98.9 per 100,000) are about 30% higher than those 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) because of differences in smoking. For liver cancer, another highly fatal cancer, 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.

The report, appearing in CA: A Cancer Journal for Clinicians and as the Special Section in Cancer Facts & Figures 2016, estimates there will be 57,740 new cancer cases and 16,910 cancer deaths among AANHPIs in 2016. The three leading causes of cancer death among AANHPI males combined are lung (27%), liver (14%), and colon/rectum (11%). Among women, they are lung (21%), breast (14%), and colon/rectum (11%).

The term Asian refers to a person with origins in the Far East, Southeast Asia, or the Indian subcontinent. This group includes, but is not limited to, Asian Indians, Cambodians, Chinese, Filipinos, Hmong, Japanese, Koreans, Pakistanis, and Vietnamese. Asian Americans represented 6.3% of the total US population in 2014 and are the fastest growing racial/ethnic group in the United States. In contrast to Hispanics, the rapid growth in the Asian American population is driven by immigration as opposed to native births.

The term “Native Hawaiian and Pacific Islander” (NHPI) refers to people with origins in Hawaii, Guam, Samoa, or other Pacific Islands. The NHPI population is also one of the fastest-growing populations in the United States. Cancer rates in this group are generally higher than those in Asian Americans.

AANHPIs are composed of diverse populations with different origins, histories, and cultures. While Asian and NHPI origins have been recognized as distinct racial groups in the U.S. Census since 2000, demographic and health data for these two groups are usually combined because of small numbers or for continuity with historical statistics. This aggregate reporting of AANHPI cancer data masks important differences between the heterogeneous AANHPI populations.

The largest Asian American subpopulation in the United States is Chinese (23%), followed by Filipino (20%), Asian Indian (18%), Vietnamese (10%), and Korean (10%). The largest NHPI subpopulation is Native Hawaiian (43%), followed by Samoan (15%), Guamanian or Chamorro (12%), and Tongan (5%). Ten US states are home to 73% of the AANHPI population; California has the largest proportion with 32% followed by New York (9%), Texas (7%), Hawaii (5%), and New Jersey (5%).