Disparities in Cancer Care and the Asian American Population

Abstract

Asian Americans are the only racial/ethnic group in the U.S. for which cancer is the leading cause of death in men and women, unlike heart disease for all other groups. Asian Americans face a confluence of cancer risks, with high rates of cancers endemic to their countries of origin because of infectious and cultural reasons, as well as increasing rates of "western" cancers that are due in part to assimilation to the American diet and lifestyle. Despite the clear mortality risk, Asian Americans are screened for cancers at lower rates than the majority of Americans. Solutions to eliminate the disparity in cancer care are complicated by language and cultural concerns of this very heterogeneous group. This review addresses the disparities in cancer screening, the historical causes, the potential contribution of racism, the importance of cultural perceptions of health care, and potential strategies to address a very complicated problem. Noting that the health care disparities faced by Asian Americans may be less conspicuous than the structural racism that has inflicted significant damage to the health of Black Americans over more than four centuries, this review is meant to raise awareness and to compel the medical establishment to recognize the urgent need to eliminate health disparities for all. The Oncologist 2021;9999:• • Implications for Practice: Cancer is the leading cause of death in Asian Americans, who face cancers endemic to their native countries, perhaps because of infectious and cultural factors, as well as those faced by all Americans, perhaps because of "westernization" in terms of diet and lifestyle. Despite the mortality rates, Asian Americans have less cancer screening than other Americans. This review highlights the need to educate both Asian Americans to improve cancer literacy and health care providers to understand the important cancer risks of the fastest-growing racial/ethnic group in the U.S. Eliminating disparities is critical to achieving an equitable society for all Americans. THE ASIAN AMERICAN POPULATION Who are Asian Americans? In the broad terms "people of color" and "underrepresented minority," Asian Americans

Harnessing Nutrition and Physical Activity for Breast Cancer Prevention and Control to Reduce Racial/Ethnic Cancer Health Disparities

“…[77][78][79][80][81][82][83][84][85] Similarly, although Asian Americans are the fastest growing racial group in the United States and their risk for developing breast cancer has been increasing, they are the least likely to exercise compared with other racial/ethnic groups, and their traditionally fruit-and vegetable-rich diet is replaced with a "Westernized" diet that is associated with obesity-related cancers. 46,[86][87][88] Therefore, these populations could benefit substantially from structured nutrition and exercise programs.…”

Factors Associated with Hepatitis B Medication Adherence and Persistence among Underserved Chinese and Vietnamese Americans

“…Liver cancer incidence and mortality are significantly high, disproportionally affecting Asian residing in the United States (U.S.). The incidence of liver cancer for Asian American men is 19.9 per 100,000 and women is 7.4 per 100,000, in comparison to 10.8 per 100,000 for non-Hispanic white men and 3.7 for non-Hispanic white women, respectively [2,3]. Chronic Hepatitis B Virus (HBV) disproportionately affects Asian Americans, where they represent 6% of the total U.S. population but make up 58% of HBV-linked hepatocellular carcinoma (HCC) cases [4].…”

“…Cancer is the leading cause of morbidity and mortality among Asian Americans [1,2]. Liver cancer incidence and mortality are significantly high, disproportionally affecting Asian residing in the United States (U.S.).…”

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

“…The clinical journey for Asian American cancer patients is fraught with challenges and barriers ( 65 ). For patients in need of health care, lack of insurance and language barriers may be insurmountable roadblocks.…”

“…For patients in need of health care, lack of insurance and language barriers may be insurmountable roadblocks. The Affordable Care Act has largely closed the insurance coverage gap between previously uninsured Asian American adults and their White counterparts, with Asian Americans having the overall lowest uninsured rate of all US racial and ethnic groups by 2018 ( 65 , 66 ). Still, a wide range in insurance rates across Asian American groups exists.…”