Breast cancer in Asian Americans in California, 1988–2013: increasing incidence trends and recent data on breast cancer subtypes
- 644 Downloads
In contrast to other US racial/ethnic groups, Asian Americans (AA) have experienced steadily increasing breast cancer rates in recent decades. To better understand potential contributors to this increase, we examined incidence trends by age and stage among women from seven AA ethnic groups in California from 1988 to 2013, and incidence patterns by subtype and age at diagnosis for the years 2009 through 2013.
Joinpoint regression was applied to California Cancer Registry data to calculate annual percentage change (APC) for incidence trends. Incidence rate ratios were used to compare rates for AA ethnic groups relative to non-Hispanic whites (NHW).
All AA groups except Japanese experienced incidence increases, with the largest among Koreans in 1988–2006 (APC 4.7, 95% CI 3.8, 5.7) and Southeast Asians in 1988–2013 (APC 2.5, 95% CI 0.8, 4.2). Among women younger than age 50, large increases occurred for Vietnamese and other Southeast Asians; among women over age 50, increasing trends occurred in all AA ethnic groups. Rates increased for distant-stage disease among Filipinas (2.2% per year, 95% CI 0.4, 3.9). Compared to NHW, Filipinas and older Vietnamese had higher incidence rates of some HER2+ subtypes.
Breast cancer incidence rates have risen rapidly among California AA, with the greatest increases in Koreans and Southeast Asians. Culturally tailored efforts to increase awareness of and attention to breast cancer risk factors are needed. Given the relatively higher rates of HER2-overexpressing subtypes in some AA ethnicities, research including these groups and their potentially unique exposures may help elucidate disease etiology.
KeywordsAsian Asian American Breast cancer Subtype Trend HER2–Neu
California cancer registry
Annual percentage change
Triple-negative breast cancer
The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement U58DP003862-01 awarded to the California Department of Public Health. The ideas and opinions expressed herein are those of the author(s) and endorsement by the State of California, Department of Public Health the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred.
SL Gomez and SL Glaser conceived and oversaw the study. M McKinley conducted the data analysis. All authors contributed substantially to the analysis and interpretation of data, revisions of the manuscript, and approval of the final version.
This work was supported by the Stanford Cancer Institute (SL Gomez, SL Glaser) and the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California (PI: SL Glaser & SL Gomez).
Compliance with ethical standards
Conflicts of interest
- 3.Tseng W, McDonnell D, Ho W, Lee C, Wong S (2010) Ethnic Health Assessment for Asian Americans, Native Hawaiians and Pacific Islanders in CaliforniaGoogle Scholar
- 4.Asian Pacific American Legal Center of Southern California (2005) The diverse face of Asians and pacific Islanders in California: Asian & Pacific Islander demographic profileGoogle Scholar
- 6.Bateman WB, Abesamis NF, Ho-Asjoe H (2009) Praeger Handbook of Asian American HealthGoogle Scholar
- 14.Hoeffel E, Rastogi S, Kim M, Shahid H The Asian population: 2010. 2010 Census Briefs 2012Google Scholar
- 16.Surveillance Research Program: National Cancer Institute. SEER*Stat software (seer.cancer.gov/seerstat)Google Scholar
- 17.Joinpoint Regression Program Version 3.5.1: Statistical Research and Applications Branch of the National Cancer Institute; July 2011Google Scholar
- 21.Kohler BA, Sherman RL, Howlader N, Jemal A, Ryerson AB, Henry KA et al (2015) Annual report to the Nation on the status of cancer, 1975–2011, featuring incidence of breast cancer subtypes by race/ethnicity, poverty, and state. J Natl Cancer Inst 107(6):djv048CrossRefPubMedPubMedCentralGoogle Scholar
- 22.Althuis MD, Fergenbaum JH, Garcia-Closas M, Brinton LA, Madigan MP, Sherman ME (2004) Etiology of hormone receptor-defined breast cancer: a systematic review of the literature. Cancer Epidemiol Biomark Prev 13(10):1558–1568Google Scholar
- 31.California Health Interview Survey (CHIS). Health Policy Fact Sheet: Asians Below State Average for Timely Mammograms; UCLA Center for Health Policy Research. April 2014Google Scholar