Disparities in Gastrointestinal Cancer Incidence in Asian American, Native Hawaiian, and Other Pacific Islander Groups

Abstract

Background and Aims

The Asian American, Native Hawaiian, and Other Pacific Islander (AANHPI) population are heterogeneous in health risk factors, socioeconomic status, and health outcomes. Disaggregating AANHPI groups may reveal disparities in cancer incidence. The aim of this study was to examine patterns and trends in incidence of common gastrointestinal cancers in AANHPI groups compared to the non-Hispanic White (NHW) population.

Methods

Using the detailed AANHPI Surveillance, Epidemiology, and End Results database, we retrospectively analyzed trends in incidence of colorectal adenocarcinoma (CRC), gastric adenocarcinoma (GC), hepatocellular carcinoma, pancreatic adenocarcinoma, and esophageal cancer from 1990 to 2014 using Surveillance, Epidemiology, and End Results∗Stat and Joinpoint software, compared to NHW. Additional analyses were stratified by age at diagnosis for CRC (<50 and ≥50 years of age), for cardia and noncardia GC, and in esophageal cancer, for squamous cell carcinoma compared to esophageal adenocarcinoma.

Results

CRC incidence was comparable in Hawaiian, Japanese, and NHW groups, with differing trends in younger and older age groups. Hepatocellular carcinoma incidence was highest in Chinese and Southeast Asian groups, while GC incidence was high in Other Pacific Islander, Korean, and Japanese groups. There was less variability in pancreatic adenocarcinoma incidence between NHW and AANHPI groups. AANHPI groups had a higher incidence of esophageal squamous cell carcinoma but a lower incidence of esophageal adenocarcinoma compared to NHW.

Conclusion

Examining incidence of common gastrointestinal cancers in disaggregated AANHPI groups reveals differences in incidence rates and disparate trends over time. Further studies are needed to elucidate the reasons for these differing trends and to evaluate whether efforts to reduce cancer risk factors and promote appropriate cancer screening in high-risk AANHPI groups are needed to reduce cancer disparities.