How Cancer Is Affecting the AANHPI Population

Death rates for certain cancers are two to three times higher for Native Hawaiian and Pacific Islanders

Rachel Nania,

AARP

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En español

Published May 02, 2024

collage of people getting screened for different cancer types on a purple background

AARP (Source: GettyImages(3))

A new report highlights cancer’s burden on one of the country’s fastest-growing populations. While the disease — most commonly diagnosed in older adults — remains the second-leading cause of death in the United States, it’s the top killer among Chinese, Filipino, Korean and Vietnamese Americans, beating out heart disease, according to research published May 1 by the American Cancer Society. Meanwhile, death rates for what health experts consider largely preventable cancers — like stomach, liver and cervical — are two to three times higher among Native Hawaiian and other Pacific Islanders compared with their white counterparts.

The report is the first of its kind to take a “disaggregated” look at cancer in the AANHPI population, which stands for Asian American, Native Hawaiian and Pacific Islander. Historically, cancer statistics for Asian Americans and Pacific Islanders have been lumped together, says report lead author Nikita Wagle, principal scientist in cancer surveillance research at the American Cancer Society.

“However, this population is so heterogeneous; there’s so much diversity,” she says. And drilling down and taking a closer look at how cancer affects each group “can better facilitate cancer prevention and early detection,” she explains.

Different groups bear different burdens

The report looked at trends in cancer incidence and deaths, and made these findings.

Prostate, lung and colorectal cancer are leading threats. The most commonly diagnosed cancer in AANHPI men overall is prostate cancer, but there are a few exceptions:

Lung cancer is the most common cancer among Chinese, Vietnamese, Laotian and Chamorro/Guamanian men.
Colorectal cancer is the most common cancer among Korean, Hmong and Cambodian men.

Breast cancer is the most common cancer among women in every AANHPI group. However, there’s variation among the groups, ranging from 17 percent of all cancers in Hmong women to 44 percent in Fijian women.

Cancer is diagnosed later in AANHPI individuals. People in AANHPI groups are generally diagnosed with cancer at a later stage compared with white individuals.

Notably, about 50 percent of breast cancers in Guamanian, Samoan, Pakistani, Tongan, Laotian and Hmong women are diagnosed at an early stage, when the cancer is most treatable, compared with 68 percent in white women and 73 percent in Japanese women.

Death disparities are striking for certain cancer types. Overall, Asian Americans are 40 percent less likely to die from cancer than white individuals in the U.S., but they are nearly 40 percent more likely to die from liver cancer and twice as likely to die from stomach cancer. Meanwhile, those in the Native Hawaiian and Pacific Islander groups have a 7 percent lower overall cancer mortality compared with white Americans, but death rates are 30 percent higher for breast cancer, 75 percent higher for liver cancer and roughly two to three times higher for cervical, stomach and uterine (endometrial) cancers.

Lung and breast cancer are the leading killers. Lung cancer is the leading cause of cancer death for all AANHPI groups. It’s also the leading cause of cancer death for women, except Filipino, Asian Indian, Samoan and Guamanian women, among whom breast cancer leads.

Survival rates are lower for many. With the exception of Asian Indian individuals, AANHPI groups have a lower overall five-year cancer survival rate compared with white individuals.

A ‘culturally tailored’ approach

A number of factors fuel the disparities highlighted in this report, researchers say. Some ethnic groups within the AANHPI population are more likely to have obesity, which is a risk factor for several types of cancer, including liver, breast and stomach. Others are more likely to smoke or face barriers to screening and treatment. That is why promoting preventive behaviors and cancer resources throughout the AANHPI population is needed, Wagle says. “However, it has to be from a culturally tailored lens, [so] that we can connect with some of these groups in a better way,” she adds.

The term “Asian” refers to a person with origins in the Far East, Southeast Asia or the Indian subcontinent, the report states, encompassing about 24 million people in the U.S. The term “Native Hawaiian and other Pacific Islander” refers to people from Hawaii, Guam, Samoa, Tonga or other Pacific islands throughout Polynesia, Micronesia and Melanesia, roughly 1.7 million people in the U.S.

“It’s essential that we acknowledge the diversity of the Asian American, Native Hawaiian and other Pacific Islander population. Consideration of cultural appropriateness, translation into native languages, improved access to health care and patient navigation could help increase knowledge and uptake of cancer screening and preventive services,” Ahmedin Jemal, senior vice president of surveillance and health equity science at the American Cancer Society, said in a statement.

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