Breast cancer in Asian Americans in California, 1988–2013: increasing incidence trends and recent data on breast cancer subtypes

  • Scarlett Lin Gomez
  • Julie Von Behren
  • Meg McKinley
  • Christina A. Clarke
  • Salma Shariff-Marco
  • Iona Cheng
  • Peggy Reynolds
  • Sally L. Glaser
Epidemiology

DOI: 10.1007/s10549-017-4229-1

Cite this article as:
Gomez, S.L., Von Behren, J., McKinley, M. et al. Breast Cancer Res Treat (2017). doi:10.1007/s10549-017-4229-1

Abstract

Purpose

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.

Methods

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).

Results

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.

Conclusions

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.

Keywords

Asian Asian American Breast cancer Subtype Trend HER2–Neu 

Abbreviations

AA

Asian American

HR

Hormone receptor

HER2

HER2–Neu

NHW

Non-hispanic white

NHB

Non-hispanic black

CCR

California cancer registry

SEER

Surveillance

Epidemiology

End results

APC

Annual percentage change

TNBC

Triple-negative breast cancer

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Scarlett Lin Gomez
    • 1
    • 2
  • Julie Von Behren
    • 1
  • Meg McKinley
    • 1
  • Christina A. Clarke
    • 1
    • 2
  • Salma Shariff-Marco
    • 1
    • 2
  • Iona Cheng
    • 1
    • 2
  • Peggy Reynolds
    • 1
    • 2
  • Sally L. Glaser
    • 1
    • 2
  1. 1.Cancer Prevention Institute of CaliforniaFremontUSA
  2. 2.Stanford Cancer InstituteStanfordUSA

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