Skip to main content

Advertisement

SpringerLink
Log in

Breast cancer in Asian Americans in California, 1988–2013: increasing incidence trends and recent data on breast cancer subtypes

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

In contrast to other US racial/ethnic groups, Asian Americans (AA) have experienced steadily increasing breast cancer rates in recent decades. To better understand potential contributors to this increase, we examined incidence trends by age and stage among women from seven AA ethnic groups in California from 1988 to 2013, and incidence patterns by subtype and age at diagnosis for the years 2009 through 2013.

Methods

Joinpoint regression was applied to California Cancer Registry data to calculate annual percentage change (APC) for incidence trends. Incidence rate ratios were used to compare rates for AA ethnic groups relative to non-Hispanic whites (NHW).

Results

All AA groups except Japanese experienced incidence increases, with the largest among Koreans in 1988–2006 (APC 4.7, 95% CI 3.8, 5.7) and Southeast Asians in 1988–2013 (APC 2.5, 95% CI 0.8, 4.2). Among women younger than age 50, large increases occurred for Vietnamese and other Southeast Asians; among women over age 50, increasing trends occurred in all AA ethnic groups. Rates increased for distant-stage disease among Filipinas (2.2% per year, 95% CI 0.4, 3.9). Compared to NHW, Filipinas and older Vietnamese had higher incidence rates of some HER2+ subtypes.

Conclusions

Breast cancer incidence rates have risen rapidly among California AA, with the greatest increases in Koreans and Southeast Asians. Culturally tailored efforts to increase awareness of and attention to breast cancer risk factors are needed. Given the relatively higher rates of HER2-overexpressing subtypes in some AA ethnicities, research including these groups and their potentially unique exposures may help elucidate disease etiology.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

AA:

Asian American

HR:

Hormone receptor

HER2:

HER2–Neu

NHW:

Non-hispanic white

NHB:

Non-hispanic black

CCR:

California cancer registry

SEER:

Surveillance

Epidemiology:

End results

APC:

Annual percentage change

TNBC:

Triple-negative breast cancer

References

  1. DeSantis CE, Fedewa SA, Goding Sauer A, Kramer JL, Smith RA, Jemal A (2016) Breast cancer statistics, 2015: convergence of incidence rates between black and white women. CA Cancer J Clin 66(1):31–42

    Article  PubMed  Google Scholar 

  2. Torre LA, Sauer AM, Chen MS Jr, Kagawa-Singer M, Jemal A, Siegel RL (2016) Cancer statistics for Asian Americans, native Hawaiians, and Pacific Islanders, 2016: converging incidence in males and females. CA Cancer J Clin 66(3):182–202

    Article  PubMed  PubMed Central  Google Scholar 

  3. Tseng W, McDonnell D, Ho W, Lee C, Wong S (2010) Ethnic Health Assessment for Asian Americans, Native Hawaiians and Pacific Islanders in California

  4. Asian Pacific American Legal Center of Southern California (2005) The diverse face of Asians and pacific Islanders in California: Asian & Pacific Islander demographic profile

  5. Frisbie WP, Cho Y, Hummer RA (2001) Immigration and the health of Asian and Pacific Islander adults in the United States. Am J Epidemiol 153(4):372–380

    Article  CAS  PubMed  Google Scholar 

  6. Bateman WB, Abesamis NF, Ho-Asjoe H (2009) Praeger Handbook of Asian American Health

  7. Gomez SL, Noone AM, Lichtensztajn DY, Scoppa S, Gibson JT, Liu L et al (2013) Cancer incidence trends among Asian American populations in the United States, 1990–2008. J Natl Cancer Inst 105(15):1096–1110

    Article  PubMed  PubMed Central  Google Scholar 

  8. Reynolds P, Hurley S, Goldberg D, Quach T, Rull R, Von Behren J (2011) An excess of breast cancer among young California-born Asian women. Ethn Dis 21(2):196–201

    PubMed  Google Scholar 

  9. Gomez SL, Quach T, Horn-Ross PL, Pham JT, Cockburn M, Chang ET et al (2010) Hidden breast cancer disparities in Asian women: disaggregating incidence rates by ethnicity and migrant status. Am J Public Health 100(Suppl 1):S125–S131

    Article  PubMed  PubMed Central  Google Scholar 

  10. Liu L, Zhang J, Wu AH, Pike MC, Deapen D (2012) Invasive breast cancer incidence trends by detailed race/ethnicity and age. Int J Cancer 130(2):395–404

    Article  CAS  PubMed  Google Scholar 

  11. Sung H, Rosenberg PS, Chen WQ, Hartman M, Lim WY, Chia KS et al (2015) Female breast cancer incidence among Asian and Western populations: more similar than expected. J Natl Cancer Inst 107(7):djv107

    Article  PubMed  PubMed Central  Google Scholar 

  12. Anderson KN, Schwab RB, Martinez ME (2014) Reproductive risk factors and breast cancer subtypes: a review of the literature. Breast Cancer Res Treat 144(1):1–10

    Article  PubMed  PubMed Central  Google Scholar 

  13. Telli ML, Chang ET, Kurian AW, Keegan TH, McClure LA, Lichtensztajn D et al (2011) Asian ethnicity and breast cancer subtypes: a study from the California cancer registry. Breast Cancer Res Treat 127(2):471–478

    Article  PubMed  Google Scholar 

  14. Hoeffel E, Rastogi S, Kim M, Shahid H The Asian population: 2010. 2010 Census Briefs 2012

  15. Howlader N, Altekruse SF, Li CI, Chen VW, Clarke CA, Ries LA et al (2014) US incidence of breast cancer subtypes defined by joint hormone receptor and HER2 status. J Natl Cancer Inst 106(5):dju055

    Article  PubMed  PubMed Central  Google Scholar 

  16. Surveillance Research Program: National Cancer Institute. SEER*Stat software (seer.cancer.gov/seerstat)

  17. Joinpoint Regression Program Version 3.5.1: Statistical Research and Applications Branch of the National Cancer Institute; July 2011

  18. Kim HJ, Fay MP, Feuer EJ, Midthune DN (2000) Permutation tests for joinpoint regression with applications to cancer rates. Stat Med 19(3):335–351

    Article  CAS  PubMed  Google Scholar 

  19. Wang Z, Bao J, Yu C, Wang J, Li C (2015) Secular trends of breast cancer in China, South Korea, Japan and the United States: application of the age-period-cohort analysis. Int J Environ Res Public Health 12(12):15409–15418

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Parise C, Caggiano V (2014) Disparities in the risk of the ER/PR/HER2 breast cancer subtypes among Asian Americans in California. Cancer Epidemiol 38(5):556–562

    Article  PubMed  Google Scholar 

  21. Kohler BA, Sherman RL, Howlader N, Jemal A, Ryerson AB, Henry KA et al (2015) Annual report to the Nation on the status of cancer, 1975–2011, featuring incidence of breast cancer subtypes by race/ethnicity, poverty, and state. J Natl Cancer Inst 107(6):djv048

    Article  PubMed  PubMed Central  Google Scholar 

  22. Althuis MD, Fergenbaum JH, Garcia-Closas M, Brinton LA, Madigan MP, Sherman ME (2004) Etiology of hormone receptor-defined breast cancer: a systematic review of the literature. Cancer Epidemiol Biomark Prev 13(10):1558–1568

    CAS  Google Scholar 

  23. Yang XR, Chang-Claude J, Goode EL, Couch FJ, Nevanlinna H, Milne RL et al (2011) Associations of breast cancer risk factors with tumor subtypes: a pooled analysis from the breast cancer association consortium studies. J Natl Cancer Inst 103(3):250–263

    Article  PubMed  Google Scholar 

  24. Akinyemiju TF, Pisu M, Waterbor JW, Altekruse SF (2015) Socioeconomic status and incidence of breast cancer by hormone receptor subtype. Springerplus 4:508

    Article  PubMed  PubMed Central  Google Scholar 

  25. Sisti JS, Collins LC, Beck AH, Tamimi RM, Rosner BA, Eliassen AH (2016) Reproductive risk factors in relation to molecular subtypes of breast cancer: results from the nurses’ health studies. Int J Cancer 138(10):2346–2356

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Chen L, Li CI, Tang MT, Porter P, Hill DA, Wiggins CL et al (2016) Reproductive factors and risk of luminal, HER2− overexpressing, and triple-negative breast cancer among multiethnic women. Cancer Epidemiol Biomark Prev 25(9):1297–1304

    Article  CAS  Google Scholar 

  27. Gomez SL, Glaser SL (2006) Misclassification of race/ethnicity in a population-based cancer registry (United States). Cancer Causes Control 17(6):771–781

    Article  PubMed  Google Scholar 

  28. Clegg LX, Reichman ME, Hankey BF, Miller BA, Lin YD, Johnson NJ et al (2007) Quality of race, Hispanic ethnicity, and immigrant status in population-based cancer registry data: implications for health disparity studies. Cancer Causes Control 18(2):177–187

    Article  PubMed  Google Scholar 

  29. Cancer Genome Atlas (2012) N. Comprehensive molecular portraits of human breast tumours. Nature 490(7418):61–70

    Article  Google Scholar 

  30. Parker JS, Mullins M, Cheang MC, Leung S, Voduc D, Vickery T et al (2009) Supervised risk predictor of breast cancer based on intrinsic subtypes. J Clin Oncol 27(8):1160–1167

    Article  PubMed  PubMed Central  Google Scholar 

  31. California Health Interview Survey (CHIS). Health Policy Fact Sheet: Asians Below State Average for Timely Mammograms; UCLA Center for Health Policy Research. April 2014

  32. Chawla N, Breen N, Liu B, Lee R, Kagawa-Singer M (2015) Asian American women in California: a pooled analysis of predictors for breast and cervical cancer screening. Am J Public Health 105(2):e98–e109

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement U58DP003862-01 awarded to the California Department of Public Health. The ideas and opinions expressed herein are those of the author(s) and endorsement by the State of California, Department of Public Health the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred.

Author’s contribution

SL Gomez and SL Glaser conceived and oversaw the study. M McKinley conducted the data analysis. All authors contributed substantially to the analysis and interpretation of data, revisions of the manuscript, and approval of the final version.

Funding

This work was supported by the Stanford Cancer Institute (SL Gomez, SL Glaser) and the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California (PI: SL Glaser & SL Gomez).

Author information

Authors and Affiliations

  1. Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94538, USA

    Scarlett Lin Gomez, Julie Von Behren, Meg McKinley, Christina A. Clarke, Salma Shariff-Marco, Iona Cheng, Peggy Reynolds & Sally L. Glaser

  2. Stanford Cancer Institute, Stanford, CA, USA

    Scarlett Lin Gomez, Christina A. Clarke, Salma Shariff-Marco, Iona Cheng, Peggy Reynolds & Sally L. Glaser

Authors
  1. Scarlett Lin Gomez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julie Von Behren
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Meg McKinley
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Christina A. Clarke
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Salma Shariff-Marco
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Iona Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Peggy Reynolds
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Sally L. Glaser
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Scarlett Lin Gomez.

Ethics declarations

Conflicts of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gomez, S.L., Von Behren, J., McKinley, M. et al. Breast cancer in Asian Americans in California, 1988–2013: increasing incidence trends and recent data on breast cancer subtypes. Breast Cancer Res Treat 164, 139–147 (2017). https://doi.org/10.1007/s10549-017-4229-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-017-4229-1

Keywords

Search

Navigation