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Going against the tide: increasing incidence of colorectal cancer among Koreans, Filipinos, and South Asians in California, 1988–2007

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Abstract

Objective

Colorectal cancer has declined markedly in California for all major racial/ethnic groups, including Asian/Pacific Islanders as a whole. Analyzing cancer data for Asian/Pacific Islanders collectively masks important differences that exist between individual Asian subgroups. This study examines secular, sex-, age-, and socioeconomic-specific trends in colorectal cancer incidence among six Asian subgroups—Chinese, Japanese, Filipino, Korean, Vietnamese, and South Asian—to determine whether these groups experienced a decline in colorectal cancer incidence and to assess possible differences in colorectal cancer incidence trends among these groups.

Methods

Cases of invasive colorectal cancer diagnosed among Japanese, Chinese, Filipinos, Koreans, Vietnamese, and South Asians between 1988 and 2007 were identified using the California Cancer Registry database. Secular, sex-, age-, and socioeconomic-specific trends in the age-adjusted colorectal cancer incidence rates for each Asian subgroup were examined using joinpoint analysis to estimate the annual percent change (APC).

Results

Among males, Koreans (APC, 3.6 %) were the only group that experienced a significant increase in colorectal cancer incidence. Among females, Koreans (APC, 2.7 %), South Asians (APC, 2.8 %), and Filipinos (APC, 1.6 %) experienced significant increases. Stratification by age at diagnosis revealed that Korean males (APC, 3.4 %) and females (APC, 2.9 %) as well as Filipino females (APC, 1.8 %) aged 50 years and older experienced a significant increase in colorectal cancer incidence. Korean males aged less than 50 years (APC, 3.4 %) also experienced a significant increase. Japanese (APC, −1.2 %) and Chinese (APC, −1.6 %) males aged 50 years and older experienced a significant decrease in colorectal cancer incidence. Stratification by socioeconomic status (SES) revealed that Korean males (APC, 2.5 %) and females (APC, 2.9 %) as well as Filipino females (APC, 2.1 %) in the lowest SES category experienced a significant increase in colorectal cancer incidence. Korean males (APC, 5.2 %) and females (APC, 3.1 %) as well as Filipino males (APC, 1.5 %) in the highest SES category also experienced a significant increase. Japanese males (APC, −2.5 %) and females (APC, −2.0 %) as well as Chinese males (APC, −2.8 %) and females (APC, −2.9 %) in the lowest SES category experienced a significant decrease. Chinese males in the middle (APC, −3.4 %) and highest (APC, −3.5 %) SES categories also experienced significant decreases in colorectal cancer incidence.

Conclusions

In contrast to the decreasing trends in colorectal cancer incidence reported among all major racial/ethnic groups including Asian/Pacific Islanders, colorectal cancer is actually increasing among some Asian subgroups in California including Korean males and females, as well as South Asian and Filipino females. Furthermore, the colorectal cancer incidence trends for these Asian subgroups differ with respect to age at diagnosis and socioeconomic status. These findings suggest that more efforts need to be made to target these populations with culturally sensitive cancer prevention and screening programs. More research is needed to examine the differences in the colorectal cancer burden among these populations.

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Acknowledgments

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 HHSN261201000036C 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 #1U58 DP000807-01 awarded to the Public Health Institute.

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Authors and Affiliations

  1. Public Health Institute, California Cancer Registry, 1825 Bell Street, Suite 102, Sacramento, CA, 95825, USA

    Brenda Hofer Giddings & Arti Parikh-Patel

  2. Cancer Surveillance Section, California Department of Public Health, Sacramento, CA, USA

    Sandy L. Kwong & Janet H. Bates

  3. Cancer Surveillance and Research Branch, California Department of Public Health, Sacramento, CA, USA

    Kurt P. Snipes

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  1. Brenda Hofer Giddings
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  2. Sandy L. Kwong
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  3. Arti Parikh-Patel
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  4. Janet H. Bates
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  5. Kurt P. Snipes
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Corresponding author

Correspondence to Brenda Hofer Giddings.

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Disclaimer: 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.

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Giddings, B.H., Kwong, S.L., Parikh-Patel, A. et al. Going against the tide: increasing incidence of colorectal cancer among Koreans, Filipinos, and South Asians in California, 1988–2007. Cancer Causes Control 23, 691–702 (2012). https://doi.org/10.1007/s10552-012-9937-6

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  • DOI: https://doi.org/10.1007/s10552-012-9937-6

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