Shattering the monolith: burden of gastrointestinal cancer in Asian Americans, Native Hawaiians, and Pacific Islanders in the United States

Abstract

Asian Americans remain the fastest-growing racial group in the United States, and are anticipated to double over the next few decades. Asian Americans are the only major racial-ethnic group for whom cancer remains the leading cause of death, and multiple gastrointestinal cancers rank among the top five incident and fatal cancers. Most research to date presents Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) in aggregate, overlooking their vast heterogeneity and hindering efforts to identify and address health disparities within AANHPI origin groups. Here, we present gastrointestinal cancer incidence and mortality in AANHPI, including disaggregated rates where feasible, and highlight gaps in current screening practices. We conclude with actionable suggestions to shift away from using broad racial categories to evaluate cancer disparities, towards high-quality, disaggregated data to better isolate and address factors driving the clear differential cancer risks among AANHPI.

Keywords: Asian American Native Hawaiian and Pacific Islander; Colorectal neoplasms; Early detection of cancer; Esophageal neoplasms; Gastrointestinal neoplasms; Health inequities; Liver neoplasms; Pancreatic neoplasms; Stomach neoplasms.

Fig. 1

Disaggregation across the data life cycle.