CPIC Researchers Illustrate the Value of Focusing Cancer Research on Distinct Subgroups Within the Asian American, Native Hawaiian and Pacific Islander Populations

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Leveraging Variations in Cancer Risks Among the Diverse AANHPI Population can Accelerate Cancer Knowledge, the researchers say

CPIC Research Scientist Scarlett Lin Gomez, Ph.D.

"We have a tremendous opportunity to draw insights into the causes of cancer and prognosis/survivorship by leveraging the heterogeneity within these populations."

The Asian American, Native Hawaiian, and Pacific Islander (AANHPI) population is collectively the most rapidly growing racial/ethnic group in the U.S., and is very diverse, representing more than 30 countries and 100 languages. Yet most cancer research still considers the AANPHI population in aggregate, as one entity, masking important differences across specific groups, according to researchers at the Cancer Prevention Institute of California (CPIC).

“Not only do they bear unique burdens of incidence and outcomes for certain cancer types, members of the AANHPI population have substantial variability in cancer incidence and survival patterns across their ethnic groups,” said CPIC research scientist Scarlett Lin Gomez, Ph.D., lead author of an editorial in the current issue of Cancer Epidemiology Biomarkers and Prevention (CEBP).

“AANHPI communities are flourishing across the country. We have a tremendous opportunity to draw insights into the causes of cancer and prognosis/survivorship by leveraging the heterogeneity within these populations,” Dr. Gomez said.

To illustrate the value of focusing cancer research on distinct subgroups within the AANHPI population, CPIC’s Asian American Working Group led a special section in the November issue of CEBP. Dr. Gomez served as guest editor of the section, which includes seven original articles – three from CPIC authors -- and a commentary on the importance of understanding this diverse community.

Summary of AANHPI Research in November Issue of CEBP

  • Cancer in Asian American and Pacific Islander Populations: Linking Research and Policy to Identify and Reduce Disparities

o    The number of Asian Americans and Pacific Islanders in the U.S. grew 46% from 2000 to 2010, and will more than double by 2060. These communities represent more than 30 different countries. Researchers, community leaders and policymakers must work together to address the unique challenges of this diverse community.
o    Tung Thanh Nguyen, University of California San Francisco, and Chair of the President’s Advisory Commission on Asian Americans and Pacific Islanders, is lead author.

  • Patient and Provider Characteristics Associated with Colorectal, Breast, and Cervical Cancer Screening among Asian Americans

o    Screening rates for AANHPIs improve when patients and physicians speak the same language and, for mammography and cervical cancer screening, when patients and their physicians are of the same gender. Culturally-tailored online health resources also may help improve preventive cancer screening in Asian populations. This study demonstrates the efficiency of using large-scale electronic health record (EHR) data to focus on specific ethnic groups.
o    Caroline A. Thompson of the Palo Alto Medical Foundation Research Institute is lead author.

  • Disaggregating Data on Asian American and Pacific Islander Women to Provide New Insights on Potential Exposures to Hazardous Air Pollutants in California

o    Recent studies suggest considerable variations in the incidence of breast cancer by AANHPI ethnic group. This study combines demographics data and air toxics data to examine average concentrations of hazardous air pollutants in areas with higher numbers of AANHPI residents. The authors demonstrate the importance of disaggregated data and highlight environmental exposure disparities among ethnic minority neighborhoods.
o    Thu Quach of CPIC is lead author.

  • Chronic Hepatitis B and Liver Cancer Risks among Asian Immigrants in New York City: Results from a Large, Community-Based Screening, Evaluation, and Treatment Program

o    Asian Americans have a high prevalence of hepatitis B infection, the major cause of liver cancer. This study found significant differences in liver cancer risk among Asian subgroups, varying by gender, age and specific place of birth, pointing to the need to identify those at higher risk for hepatitis B infection and target them for screening and treatment.
o    Henry J. Pollack of New York University School of Medicine is lead author.

  • 1,3-Butadiene Exposure and Metabolism among Japanese American, Native Hawaiian, and White Smokers

o    Differences in lung cancer risk among Native Hawaiians, Whites, and Japanese Americans may be explained by variations in the ability to metabolize certain carcinogens contained in cigarette smoke. Differences in excretion levels are partly due to genetics. Levels are higher in whites and lower in Japanese-Americans, which is consistent with each group’s risk of lung cancer.
o    Sungshim Lani Park of the University of Southern California is lead author.

  • Lung Cancer Incidence Trends by Histology Type among Asian American, Native Hawaiian, and Pacific Islander Populations in the United States, 1990–2010

o    Lung cancer is one of the most commonly diagnosed cancers in the AANHPI population. Researchers examined different types of lung cancer in distinct ethnic groups and found significant increases in the incidence of adenocarcinoma among Filipino and Korean women, who have a low prevalence of smoking, and Chinese men. The findings underscore the need for research into factors other than smoking in distinct populations.
o    Iona Cheng and Gem Le of CPIC are co-lead authors.

  • Disaggregated Data and Beyond: Future Queries in Cancer Control Research

o    A commentary on the “model minority” myth and why it persists, providing context for social and cultural factors that shape health and disease for AANHPI populations, and strategies needed to advance research and health policy.
o    Anh Bao Nguyen of the National Cancer Institute is the lead author.

According to Dr. Gomez and the Asian American Working Group at CPIC, federally funded research for AANHPI populations is sparse. These groups are not well represented in cancer epidemiologic cohorts, leading to limited availability of relevant and targeted information needed to study growing populations of AANHPIs.

“Through investing in cancer research, we have a unique opportunity to accelerate the availability of cancer knowledge that is useful and impactful for the many distinct Asian American, native Hawaiian and Pacific Islander population groups that reside throughout the country,” Dr. Gomez said.

CPIC and the Stanford Cancer Institute supported this work.

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About the Cancer Prevention Institute of California
The Cancer Prevention Institute of California (CPIC) is the nation’s premier organization dedicated to preventing cancer and to reducing its burden where it cannot yet be prevented. CPIC tracks patterns of cancer throughout the entire population and identifies those at risk for developing cancer. Its research scientists are leaders in investigating the causes of cancer in large populations to advance the development of prevention-focused interventions. CPIC’s innovative cancer prevention research and education programs, together with the work of the Stanford Cancer Institute, deliver a comprehensive arsenal for defeating cancer. For more information, visit http://www.cpic.org.

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