California researchers are leading a nationwide effort to find out why some Asian American communities have high rates of certain cancers.
It comes as health experts see rising rates of lung cancer among Asian American women who have never smoked and increasing rates of early-onset breast cancer.
“Asian Americans are actually the first racial and ethnic group for whom cancer is the leading cause of death,” said Scarlett Gomez, a cancer epidemiologist at UC San Francisco and a lead on the project.
UCSF joins researchers from UC Irvine, UC Davis, Cedars-Sinai and Temple University in launching a $12.5 million National Cancer Institute-funded study called the ASPIRE Cohort, that will follow 20,000 Asian Americans over time. Researchers say it’s the first large-scale longitudinal cancer study focused on Asian Americans.
Lung cancer incidence has declined across much of the United States as smoking rates have fallen. However, researchers have observed a slight increase among Asian Americans, despite relatively low smoking rates, particularly among women. More than half of Asian American women diagnosed with lung cancer are nonsmokers, they say.
Many existing studies of lung cancer risk among nonsmokers have been conducted in Asia, where exposure patterns can differ significantly from those in the United States, said Iona Cheng, a molecular epidemiologist at UCSF and also a lead on the project.
Researchers know that outdoor air pollution, secondhand smoke and cooking oil fumes can contribute to lung cancer risk. But it’s not clear if these explain disease patterns among Asian Americans in the United States.
Rising rates of breast cancer among Asian American women are also driving the push.
“Early onset breast cancer” — diagnosed before age 50 — “is going up the fastest among Asian Americans,” Gomez said. Recent data show rates among Asian Americans, Native Hawaiians and Pacific Islanders are approaching those of non-Hispanic white women, she said. Cancer experts don’t know why.
One of the central goals of the ASPIRE study is to move beyond treating Asian Americans as a single category. The term can include people with roots in dozens of countries from Sri Lanka to China’s border with Russia to Pacific islands, with completely different exposure patterns and cuisines.
“When we separate and look at all the distinct Asian ethnicities, we see a wide variation,” Cheng said.
Filipino women have a higher incidence of thyroid cancer, and stomach cancer has been more common among some Korean and Japanese people. Combining all Asian Americans into one category can make those differences impossible to detect.
The study also seeks to address longstanding gaps in representation. Although Asian Americans make up nearly 8% of the U.S. population, they have historically received little research funding.
Existing cancer studies have also often included too few Asian Americans to draw meaningful conclusions about specific ethnic groups, researchers said. Salma Shariff-Marco, a social and behavioral scientist at UCSF and also a lead on the projects, aid that has made it hard to show the need for more targeted research. The ASPIRE cohort, she said, is designed to show the variation by including a broader range of ethnic groups and more contemporary exposures than previous work.
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