Epidemiology of Non-small Cell Lung Cancer in Asian Americans: Incidence Patterns Among Six Subgroups by Nativity

Abstract

Background Differences in the epidemiology of lung cancer between Asians and non-Hispanic Whites have brought to light the relative influences of genetic and environmental factors on lung cancer risk. We set out to describe the epidemiology of non-small cell lung cancer (NSCLC) among Asians living in California, and to explore the effects of acculturation on lung cancer risk by comparing lung cancer rates between U.S.-born and foreign-born Asians. Methods Age-adjusted incidence rates of NSCLC were calculated for Chinese, Filipino, Japanese, Korean, Vietnamese, and South Asians in California between 1988 and 2003, using data from the California Cancer Registry. Incidence rates were calculated and stratified by sex and nativity. We analyzed population-based tobacco smoking prevalence data to determine whether differences in rates were associated with prevalence of tobacco smoking. Results Asians have overall lower incidence rates of NSCLC compared with Whites (29.8 and 57.7 per 100,000, respectively). South Asians have markedly low rates of NSCLC (12.0 per 100,000). Foreign-born Asian men and women have an approximately 35% higher rate of NSCLC than U.S.-born Asian men and women. The incidence pattern by nativity is consistent with the population prevalence of smoking among Asian men; however, among women, the prevalence of smoking is higher among U.S.-born, which is counter to their incidence patterns. Conclusions Foreign-born Asians have a higher rate of NSCLC than U.S.-born Asians, which may be due to environmental tobacco smoke or non-tobacco exposures among women. South Asians have a remarkably low rate of NSCLC that approaches Caucasian levels among the U.S.-born. More studies with individual-level survey data are needed to identify the specific environmental factors associated with differential lung cancer risk occurring with acculturation among Asians.

Age‐ and time‐dependent changes in cancer incidence among immigrants to Sweden: colorectal, lung, breast and prostate cancers

“…23 Swedish men have a relatively low rate of lung cancer. 24,25 The prevalence of smoking peaked in Sweden at some 45% for men and 35% for women in the 1960-1970s, subsequently reached to the less than 20% in the 2000s.…”

The Analysis Between Functional Human Telomerase Reverse Transcriptase MNS16A Polymorphisms and the Risk of Developing Non-Small Cell Lung Cancer in the Taiwanese Population

“…1 Although the causative carcinogens for this type of lung adenocarcinoma are unknown, it is speculated that certain genetic or environmental risk factors might predispose these specific Taiwanese population to lung carcinogenesis. 2,3 Telomeres are essential units that stabilize eukaryotic chromosomes and undergo progressive loss with cell division in somatic cells. 4 The shortening of telomeres results in chromosomal instability and induces cell senescence.…”

Lung cancer early detection and health disparities: the intersection of epigenetics and ethnicity

“…In spite of recent declines in incidence rates among Caucasians and the United States population as a whole, Asian Americans exhibited stable incidence trends between 1990 and 2008 (39). Additionally, lung cancer rates among Asian American women are higher than those of the general population despite their lower smoking rates (39)(40)(41)(42). Conversely, groups with Hispanic heritage are 40-50% less likely to be diagnosed with lung cancer when compared with Caucasians (43)(44)(45)(46).…”