Charting a Path Towards Asian American Cancer Health Equity: A Way Forward

Abstract

On July 29, 2021, the US Food and Drug Administration’s Oncology Center of Excellence convened Conversations on Cancer. This Conversation, the first ever by the US Food and Drug Administration, focused on Asian Americans and served as the platform for this Commentary. Panelists elaborated on topics ranging from heterogeneity in Asian American demographics to racism through a path to health equity and supplemented this Commentary with literature citations. Asian Americans are the fastest-growing US race group, yet data aggregation obscures distinctions and cancer disparities within the more than 24 million Asians living in the United States with harmful impacts on communities and patients, as illustrated by breast cancer survivor Susan Shinagawa’s patient-to-advocate journey. Bigotry against Asian Americans has been pervasive since the 19th century, but especially during the COVID-19 pandemic. Asian Americans are unique as the first US population to experience cancer as the leading cause of death. Asian Americans are disproportionately affected by cancers because of infectious origins and have the highest rates of lung cancer among never-smoking women. The infinitesimal proportion of the National Institutes of Health’s budget compared with experiencing the highest percentage increases of any US racial population more than 3 decades highlights the dearth of focused research among Asian Americans. Recognizing the heterogeneity of Asian Americans and that disaggregated data are critical for accurately characterizing distinct ethnic groups, focusing on the impact of racism and COVID-19 on cancer disparities, and focusing and prioritizing funding resources are necessary steps forward for achieving health equity for Asian Americans.

Racial and Ethnic Inequities in Cancer Care Continuity During the COVID-19 Pandemic Among Those With SARS-CoV-2

“…First, an important consequence of the pandemic was an increase in xenophobia and anti-Asian sentiment and associated targeted crimes in the United States, which had adverse impacts on health care-seeking behaviors, particularly among older Asian individuals. [36][37][38] Second, particularly relevant to our study setting, Asian Americans had the highest US COVID-19 hospitalization and mortality rates compared with other racial groups. 39,40 Finally, Asian Americans led the nation in long-term COVID-19-related unemployment given the overrepresentation of essential workers at both ends of the socioeconomic or occupational spectrum from US health care workers to low-wage, no-benefits, front-line workers.…”

Survival of Filipino women with breast cancer in the United States

“…51 As a result, healthcare providers' assumption of the model minority myth may lead to neglect of screening and healthy lifestyle recommendations. 51 We highlight that not all Asian American women with breast cancer experience as good survival outcomes as Filipina Americans and aggregating health data among the Asian American subgroups masks these clinically relevant within-group differences. 72 There are several limitations to our study.…”

Advancing equity through strengthening research on health and well-being of Asian American, Native Hawaiian, and Pacific Islander

“…Asian American (AA), Native Hawaiian and Pacific Islander (NHPI) populations are highly heterogeneous racial/ethnic groups with diverse health disparity concerns including hepatitis B and chronic liver disease, diabetes without obesity, various types of cancer, and stroke etc. [ 1 , 2 ]. AA and NHPI populations also often face obstacles in seeking quality medical care.…”