United States Whites Research Articles

Abstract IA17: Observations and implications from examining cancer incidence rates and trends of ethnic Asian Americans

Abstract Asian Americans are a fast-growing population group in the United States (US). The substantial heterogeneity within them (e.g., by origin, language, culture, immigration history, socioeconomic status, degree of acculturation, etc.) and its impact on health and cancer disparities are increasingly being recognized. Except for Japanese Americans, the majority of the ethnic Asian Americans are foreign-born. Monitoring cancer incidence rates and trends among immigrant populations, especially in comparison with those of their countries of origin and US, can provide valuable information for understanding cancer etiology and identifying modifiable environmental and behavioral risk factors. As population mobility increases globally with time, this area of research will become more important and needed. The Los Angeles Cancer Surveillance Program (LACSP) is the population-based cancer registry for Los Angeles County (LAC) in California with over 10 million residents. It is a member of the California Cancer Registry (CCR) and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. It is also the only U.S. cancer registry that has consistently reported cancer incidence for four ethnic Asian American populations (i.e., Chinese, Filipinos, Japanese, and Koreans) in its catchment area, which allows the comparisons of these largely immigrant populations against those of their countries of origin and US whites. The standardized and detailed data from LACSP and around the world published in the Cancer in Five Continents (CI5) volumes have enabled numerous international comparison studies. We used the CI5 online analysis tool, CI5plus, and extracted age-adjusted incidence rates by sex and cancer site in LAC for Chinese, Filipinos, Japanese, and Koreans, respectively, to compare with rates from China, Philippines, Japan, and South Korea, as well as those for whites from the SEER registries for the period of 1973-2012. We observed: 1) Cancer-specific incidence rates among all four Asian ethnic groups in LAC have deviated from the rates in their countries of origin to approaching US whites; 2) although their risks for some cancers decreased (e.g., cervical, gastric, and liver), their risks for other cancers increased (e.g., breast, uterine, non-Hodgkin lymphoma, and testicular); and 3) Filipino Americans display rather different cancer risk profiles from other ethnic Asian Americans. Our findings highlight the important changes in cancer-specific incidence rates and trends among the ethnic Asian American subgroups as compared to those of their countries of origin. These changes underline the significance of nongenetic factors, including environmental, behavioral, and lifestyle factors, in cancer development and deserve further attention. Along with existing literature on known differences in cancer risk among these subpopulations, our work will help establish priorities to decrease cancer burden among Asian immigrants. Citation Format: Lihua Liu, Juanjuan Zhang, Andrea Sipin-Baliwas, Amie Hwang, Mariana C. Stern, Myles Cockburn, Dennis Deapen. Observations and implications from examining cancer incidence rates and trends of ethnic Asian Americans [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr IA17.

A population-based study of Kurdish breast cancer in northern Iraq: Hormone receptor and HER2 status. A comparison with Arabic women and United States SEER data

BackgroundHormone receptor (HR) and HER2 expression predict the therapeutic response and prognosis of breast cancer. In the Middle-East, breast cancer is diagnosed at a young age, and Arabic women are reported to have a low frequency of HR positive tumors. This study investigates HR and HER2 expression among Kurdish and Arabic women.MethodsDuring 2008–2010, the Sulaimaniyah Directorate of Health records identified 514 Sulaimaniyah Kurdish women, 227 Kurdish women of other Governates, and 83 Arabic women with a first diagnosis of breast cancer. The breast cancers of 432 women had immunohistochemistry (IHC) performed for estrogen and progesterone receptors (ER and PR) and HER2. Age specific and age standardized incidence rates were calculated for Sulaimaniyah Kurds. Results were compared with Egypt and with United States (US) SEER data.ResultsThe median patient age was 46 years and 60.4% were < 50 years old. Tumors of 65.2% of women were ER+/HER2- with the rate increasing to 78.3% in patients ≥ 60 years old in proportions similar to US whites. The total annual age standardized incidence for breast cancer among Sulaimaniyah Kurds was 40.5/100,000 women, a rate similar to Egypt but much lower than the US. By HR/HER2 subtype, the highest age specific incidence rates were 16.4 and 45.4/100,000 for ER+/PR+/HER2- tumors in women < 50 or ≥ 50 years old, respectively (US whites: 37.7 and 226.1/100,000). Tumors of 20.4% of Sulaimaniyah women were HER2+ with annual incidence rates for ER-/PR-/HER2+ tumors of women <50 or ≥ 50 years old being 4.0 and 6.3/100,000 (US whites: 3.2 and 14.4/100,000). No significant differences in ER or HER2 status were found between Kurdish and Arabic patients.ConclusionsCompared to the US, low age standardized and age specific breast cancer incidence rates were found in Kurdish women; nevertheless, the proportional expression of HR and HER2 for both Kurds and Arabs was comparable to that of US white women. The great majority of the breast cancer was ER+/HER2- and should respond to anti-estrogen therapy.

Cancer incidence rates among South Asians in four geographic regions: India, Singapore, UK and US

Data are limited regarding cancer incidence among Indians residing in different geographic regions around the world. Examining such rates may provide us with insights into future aetiological research possibilities as well as screening and prevention. Incidence rates for all cancers combined and 19 specific cancers were obtained for India from Globocan 2002, for Indians in Singapore from Cancer Incidence in Five Continents (VIII), and from national data sources for South Asians (SA) in the United Kingdom (UK) and for Asian Indians/Pakistanis (AIP) and whites in the United States (US). We observed the lowest total cancer incidence rates in India (111 and 116 per 100,000 among males and females, respectively, age-standardized to the 1960 world population) and the highest among US whites (362 and 296). Cancer incidence rates among Indians residing outside of India were: intermediate Singapore (102 and 132), UK (173 and 179) and US ranges 152-176 and 142-164. A similar pattern was observed for cancers of the colorectum, prostate, thyroid, pancreas, lung, breast and non-Hodgkin lymphoma. In contrast, rates for cancers of the oral cavity, oesophagus, larynx and cervix uteri were highest in India. Although little geographic variability was apparent for stomach cancer incidence, Indians in Singapore had the highest rates compared with any other region. The UK SA and the US AIP appear with adopt the cancer patterns of their host country. Variations in environmental exposures such as tobacco use, diet and infection, as well as better health care access and knowledge may explain some of the observed incidence differences.

Increasing colorectal cancer incidence rates in Japan.

We examined trends of colorectal cancer incidence rates among Japanese (Miyagi Prefecture) and United States (US) whites (State of Connecticut) between 1959 and 1992. Age-standardized rates in Japan have increased dramatically and are now similar to US white rates. For both colon and rectum, age-specific rates in Japanese men born after 1930 exceed those in US whites, and the Japanese excess increases with year of birth. Similar patterns are evident for women. The current trends suggest that colorectal cancer will become a major source of morbidity and mortality in Japan, as these young Japanese age and their risks increase.

Transfusion-associated graft-versus-host disease.

Transfusion-associated graft-versus-host disease.

Opposing national stroke mortality trends in Poland and for African Americans and whites in the United States, 1968 to 1994.

The United States (US) has experienced declines in stroke mortality in contrast to the increases reported for Poland. As part of the Poland and US Agreement on Cardiovascular and Cardiopulmonary Research, stroke mortality trends in Polish and US subpopulations were compared in the context of cross-population differences in competing causes of death and determinants of stroke. Age-adjusted annual stroke, cardiovascular disease (CVD), non-CVD, and all-cause mortality rates were determined for men and women aged 35 to 64 and 65 to 74 years from 1968 to 1994 for African Americans and US whites and in Poland. Mean annual percent changes of mortality rates were estimated during 1968 to 1980 and 1981 to 1994 with the use of piecewise log-linear regression. US stroke mortality rates declined 3.7% to 4.8% annually during 1968 to 1980 and 2.0% to 3.1% during 1981 to 1994, with similar declines in each ethnic, gender, and age group. Polish rates increased 3.3% to 5.5% annually for all age-gender groups in Poland during 1968 to 1980. Polish men aged 35 to 64 experienced increasing rates during 1981 to 1994 (1.6% annually), while Polish women and older men experienced slight declines or little change. Only Polish men aged 35 to 64 years exhibited increases in stroke, CVD, and non-CVD mortality rates during both time intervals. Poland and the US experienced opposing stroke mortality rate trends between 1968 and 1994. These national and ethnic trends occurring in just one generation suggest major effects of lifestyle, socioenvironmental, and/or medical care determinants.