Breast cancer on the rise among Asian-Americans

April 26, 2017 by Tracy Seipel, The Mercury News
Micrograph showing a lymph node invaded by ductal breast carcinoma, with extension of the tumour beyond the lymph node. Credit: Nephron/Wikipedia

When Margaret Abe-Koga was diagnosed with breast cancer in 2015, she was as surprised as anyone.

After all, no one ever had in her Japanese-American family, she doesn't have the genetic marker, and she'd been led to believe that Asian-Americans weren't - as Abe-Koga put it - "a high-propensity group" for the disease.

But fate proved otherwise for the three-term Mountain View city councilwoman, as it has for a growing number of Asian-Americans in California confronting a sobering trend: While breast cancer rates have plateaued or declined in some racial groups, they have been steadily rising among Asian-Americans since 1988.

The new findings, released last week by the Fremont-based Cancer Prevention Institute of California, show the largest increase in breast cancer rates in the Golden State is occurring among Koreans and Southeast Asians. Japanese-Americans showed the slowest increases, but suffered the highest breast cancer rates among seven Asian-American groups in the study.

The results stunned Abe-Koga, 46, who in January went through breast reconstruction surgery after undergoing a double mastectomy, chemotherapy and radiation. For generations, she said, Asian-Americans have been under the wrong impression that breast cancer "is not prevalent in our community" so "it's not something that people think about."

"I started to think maybe there is that aspect within our community: Our folks are more silent about what they are going through and don't necessarily share, or they aren't getting the testing they should get," she said.

The confusion among Asian-American women is understandable. As of 2013, the U.S. Centers for Disease Control and Prevention reported that white women had the highest rate of breast cancer, followed by black, Hispanic, Asian/Pacific Islander and American Indian/Alaska Native women.

But the CDC's numbers are nationwide. By comparison, the new study is based on the California Cancer Registry in a state that has the largest population of Asian-Americans in the country. With a population of approximately 5.7 million in California, Asian-Americans now make up about 15 percent of the state's population.

Scarlett Lin Gomez, the study's lead author, said the results are revealing because they are the first to evaluate patterns among seven major Asian-American ethnic groups, by age and stage of cancer.

It showed breast cancer rates rose among Korean women in California an astonishing 4.7 percent each year from 1988 to 2006, before slightly declining over the next seven years. The rates climbed 2.5 percent a year between 1998-2013 among Southeast Asians (Cambodians, Laotians, Hmong and Thai), and 1.4 percent among South Asians (Indians and Pakistanis).

There is no consensus on why breast cancer rates are on the rise among Asian-Americans. But risk factors could include delaying childbirth, changing diets, a rise in obesity and alcohol use. Better screening could also be a reason behind the increase.

Early studies from the 1970s and 1980s showed increasing breast cancer rates among Japanese-Americans, but they have leveled off. Lin Gomez said that may be because Japanese have been in the U.S. longer than the other Asian ethnic groups whose numbers are growing.

"We know that increases with acculturation - that is, adoption of Western lifestyles," Lin Gomez said. And that is consistent with the fact that the most rapidly increasing breast cancer rates are seen among the more recently immigrated groups such as Koreans, South Asians, and Southeast Asians.

The study hits close to home for Lin Gomez, who is Chinese-American, and said aspects of the Asian culture could be contributing to the growing numbers, including a tendency to consider cancer a stigma - and to keep quiet within a family.

Grace Yoo, a professor of Asian-American Studies at San Francisco State University who has written extensively on Asian-American health issues, including breast cancer, is familiar with those sentiments.

There is a perception among some Asian-Americans that breast cancer is "a white woman's disease," Yoo said. "It's just not on their radar."

Yoo said many Asian-Americans arrive in the U.S. with no family history of the disease "so there isn't that intergenerational communication" around the importance of breast cancer screenings. Diagnosed at later stages, these women then face greater mortality than their white counterparts, she said.

And because many of these women equate the diagnosis as a death sentence, she said, they may not aggressively pursue treatment.

The study notes increasing trends of late-stage cancer among Asian-Americans - particularly among Filipino, Korean and South Asian women, who are the least likely to get screened.

In 2015, Sherry Cava and her three children arrived in the U.S. from her native Philippines to join her mother in Daly City. About a month later, she felt a lump in her breast. Cava, now 44, had never had a mammogram or even routine annual checkups after her three pregnancies, because of the prohibitive cost of health care.

"In the Philippines, when you don't feel anything, you don't go to the doctor," Cava said. "It's only when you're experiencing constant pain that you go."

But after she told a cousin, a nurse at San Francisco General Hospital, about the lump, she was able to get a mammography, ultrasound and biopsy done on the same day, Cava said.

Like Abe-Koga, her involved chemotherapy, a mastectomy and radiation. But Cava's family did have a history of the disease: Her 70-year-old maternal grandmother had been successfully treated for it.

Cava, who completed her last cancer treatments last summer, said she believes if she had not come to America, her would not have been caught as early.

"I am blessed to be here at this moment," she said.

Explore further: Cancer no. 1 killer of Asian-Americans, Hawaiians, Pacific Islanders: study


Related Stories

Cancer no. 1 killer of Asian-Americans, Hawaiians, Pacific Islanders: study

January 14, 2016
(HealthDay)—Cancer is the leading cause of death among Asian Americans, Native Hawaiians and Pacific Islanders, even though overall cancer incidence and death rates in these groups are lower than among white Americans, ...

Asian-Americans are at high risk for diabetes but rarely get screened

November 15, 2016
Less than half of Asian Americans who ought to be screened for type 2 diabetes actually get tested, according to a study published Nov. 15, 2016, in the Journal of General Internal Medicine. Asian Americans have a high prevalence ...

Cancer mortality differs among Asian ethnic groups

October 3, 2016
The growing Asian American population in the United States presents a diverse set of health behaviors and health outcomes, and may benefit from cancer prevention and screening efforts tailored to specific Asian ethnic groups, ...

Minority women less likely to get breast cancer screening

December 16, 2016
(HealthDay)—Black and Hispanic women are less likely than white women to be screened for breast cancer, a large review finds.

South-Asian women more likely to be diagnosed with later stage breast cancer: Study

April 20, 2015
South Asian women are more likely to be diagnosed with later stage breast cancer compared to the general population, while Chinese women are more likely to be diagnosed with early stage cancer, according to a new study by ...

New model more accurately predicts breast cancer risk in Hispanic women

December 20, 2016
A new breast cancer model, published today in the Journal of the National Cancer Institute, will help health care providers more accurately predict breast cancer risk in their Hispanic patients.

Recommended for you

Why some cancers affect only young women

October 19, 2018
Among several forms of pancreatic cancer, one of them specifically affects women, often young. How is this possible, even though the pancreas is an organ with little exposure to sex hormones? This pancreatic cancer, known ...

Scientists to improve cancer treatment effectiveness

October 19, 2018
Together with researchers from the University of Nantes and the University of Reims Champagne-Ardenne in France, experts from the National Research Nuclear University MEPhI have recently developed a quantum dot-based microarray ...

Mutant cells colonize our tissues over our lifetime

October 18, 2018
By the time we reach middle age, more than half of the oesophagus in healthy people has been taken over by cells carrying mutations in cancer genes, scientists have uncovered. By studying normal oesophagus tissue, scientists ...

Study involving hundreds of patient samples may reveal new treatment options of leukemia

October 17, 2018
After more than five years and 672 patient samples, an OHSU research team has published the largest cancer dataset of its kind for a form of leukemia. The study, "Functional Genomic Landscape of Acute Myeloid Leukemia", published ...

A 150-year-old drug might improve radiation therapy for cancer

October 17, 2018
A drug first identified 150 years ago and used as a smooth-muscle relaxant might make tumors more sensitive to radiation therapy, according to a recent study led by researchers at The Ohio State University Comprehensive Cancer ...

Loss of protein p53 helps cancer cells multiply in 'unfavourable' conditions

October 17, 2018
Researchers have discovered a novel consequence of loss of the tumour protein p53 that promotes cancer development, according to new findings in eLife.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.