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. 2022 Jan;31(1):58-65.
doi: 10.1158/1055-9965.EPI-21-0359. Epub 2021 Oct 25.

Cancer Mortality in U.S.-Born versus Foreign-Born Asian American Groups (2008-2017)

Osika Tripathi  1   2   3 , Yuelin He  3   4 , Bridgette Y Han  3   5 , Darynn G Paragas  3   6   7 , Nora Sharp  3   4 , Shozen Dan  3 , Malathi Srinivasan  3   8 , Latha P Palaniappan  3   8 , Caroline A Thompson  9   2
Affiliations

Cancer Mortality in U.S.-Born versus Foreign-Born Asian American Groups (2008-2017)

Osika Tripathi et al. Cancer Epidemiol Biomarkers Prev. 2022 Jan.

Abstract

Background: Asian Americans (AA) are the fastest growing ethnic group in the United States with high proportions of immigrants. Nativity is important as cancer risk factors vary by country. We sought to understand differences in cancer mortality among AAs by nativity (foreign-born vs. U.S.-born).

Methods: Ninety-eight thousand eight hundred and twenty-six AA (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) decedents with cancer-related deaths from U.S. death certificates (2008-2017) were analyzed. Thirteen cancers that contribute significantly to Asian-American cancer mortality were selected and categorized by etiology: tobacco-related, screen-detected, diet-/obesity-related, and infection-related. Ten-year age-adjusted mortality rates [AAMR; 95% confidence interval (CI); per 100,00] and standardized mortality ratios (SMR; 95% CI) using foreign-born as the reference group were calculated.

Results: Overall, foreign-born AAs had higher mortality rates than U.S.-born. Japanese U.S.-born males had the highest tobacco-related mortality rates [foreign-born AAMR: 43.02 (38.72, 47.31); U.S.-born AAMR: 55.38 (53.05, 57.72)]. Screen-detected death rates were higher for foreign-born than U.S.-born, except for among Japanese males [SMR 1.28 (1.21-1.35)]. Diet-/obesity-related AAMRs were higher among females than males and highest among foreign-born females. Foreign-born males and females had higher infection-related AAMRs than U.S.-born; the highest rates were foreign-born males-Korean [AAMR 41.54 (39.54, 43.53)] and Vietnamese [AAMR 41.39 (39.68, 43.09)].

Conclusions: We observed substantial heterogeneity in mortality rates across AA groups and by nativity. Contrary to the Healthy Immigrant Effect, most foreign-born Asians were dying at higher rates than U.S.-born AAs.

Impact: Disaggregated analysis of AA cancers, targeted and culturally tailored cancer screening, and treatments for infections among foreign-born Asians is critical for cancer prevention efforts.

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Conflict of interest statement

Disclosure of Potential Conflicts of Interest: The authors declare no potential conflicts of interest.

Figures

Figures 1:
Figures 1:. Age-adjusted moratlity rates (per 100,000) by etiology, race, and nativity, among males
Rates are directly age-adjusted to the US 2000 population. Due to counts <16, rates for infection related cancer among US born Asian Indians and Vietnamese are suppressed and not reported. Tobacco related cancers: oral cavity & pharynx, leukemia, lung & bronchus, kidney & renal, pancreas; Screen detected cancers: colon & rectum, female breast, prostate; Diet/Obseity related cancers: colon & rectum, female breast, ovary, uterine corpus; Infection related cancers: oral cavity & pharynx, liver, non-Hodgkin lymphoma, stomach.
Figure 2:
Figure 2:. Age-adjusted moratlity rates (per 100,000) by etiology, race, and nativity, among females
Rates are directly age-adjusted to the US 2000 population. Due to counts <16, rates for infection related cancer among US born Asian Indians and Vietnamese are suppressed and not reported. Tobacco related cancers: oral cavity & pharynx, leukemia, lung & bronchus, kidney & renal, pancreas; Screen detected cancers: colon & rectum, female breast, prostate; Diet/Obseity related cancers: colon & rectum, female breast, ovary, uterine corpus; Infection related cancers: oral cavity & pharynx, liver, non-Hodgkin lymphoma, stomach.
Figure 3:
Figure 3:. Standardized mortality ratios (SMR) comparing US-born to foreign-born (reference), by sex, etiology, and race.
SMRs were indirectly standardized and are not valid for cross group comparisons but do allow for the comparison of foreign vs. US-born decedents within each AA group. SMR (95% CI) presented on logarithmic scale. Tobacco related cancers: oral cavity & pharynx, leukemia, lung & bronchus, kidney & renal, pancreas; Screen detected cancers: colon & rectum, female breast, prostate; Diet/Obseity related cancers: colon & rectum, female breast, ovary, uterine corpus; Infection related cancers: oral cavity & pharynx, liver, non-Hodgkin lymphoma, stomach
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  • Selected Articles from This Issue.
    [No authors listed] [No authors listed] Cancer Epidemiol Biomarkers Prev. 2022 Jan;31(1):1. doi: 10.1158/1055-9965.EPI-31-1-HI. Cancer Epidemiol Biomarkers Prev. 2022. PMID: 35017191 No abstract available.

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