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Newswise — The incidence of gastrointestinal cancers varies across Asian American, Native Hawaiian and other Pacific Islander communities, according to a study  March 15 in the journal Gastro Hep Advances. 

When combined, Asian American, Native Hawaiian and other Pacific Islander  communities compose the fastest-growing group in the United States. They accounted for 6.2% of the population in 2020, according to the U.S. Census. 

The lead author is Dr. Vicki Tang, an internal medicine resident at the University of Washington School of Medicine. UW Medicine gastroenterologist Dr. Cynthia Ko, associate professor of medicine, was her coauthor. 

Among the subpopulations, researchers also found marked differences in health outcomes, socioeconomic status, education, and immigration status that can be easily obscured when these groups are characterized as a single population, the authors wrote. 

These differences challenge the presumption that gastrointestinal cancers affect each subpopulation similarly, Tang noted.  

The authors studied the Surveillance, Epidemiology and End Results data from 1990 to 2014, and found variability across the subgroups in terms of gastrointestinal cancers.  

They analyzed data for colorectal, hepatocellular, gastric, pancreatic and esophageal cancers.  A different GI cancer appeared to be predominant in each subpopulation.  

“Even though you’re looking at a small population of people, in this study, it does a disservice to completely put them in one group,” Tang said.   

Findings included:  

• Overall, colorectal cancer incidence was comparable among Hawaiian, Japanese and non-Hispanic white groups. But when the data on the groups were examined by age, the trends began to diverge. In the non-Hispanic white group, colorectal cancer incidence decreased among those 50 and older but increased in those under age 50.  The trends in these age groups differed in the various subpopulations.  
• Hepatocellular carcinoma, or liver cancer, was highest in Korean, Chinese, other Pacific Islander and Southeast Asian communities. 
• Gastric cancer was higher in Pacific Islander, Korean and Japanese communities. 
• All the American Asian, Native Hawaiian and Pacific Islander groups had a higher incidence of esophageal squamous cancer, but a lower incidence of another type of esophageal cancer (adenocarcinoma) compared to non-Hispanic whites.  
• Asian Indian/Pakistani and other Pacific Islander groups had relatively lower incidences of colorectal cancer. In contrast, colorectal cancer incidence was higher in Japanese and Hawaiian groups, and similar to the incidence in non-Hispanic whites. 
•  While researchers found that colorectal cancer incidence was highest in Japanese and Filipino groups from 1990-2014, the American Cancer Society reports colorectal cancer is the most diagnosed cancer in Korean, Hmong and Cambodian Americans in 2023, the authors noted. 

More studies are needed to determine the “why” of these differences, Tang said, which could lead to effective screening and interventions within each community. Addressing the most common causes of gastrointestinal cancers in the subpopulations and adjusting screening recommendations for the most common cancers may help reduce the number of cancer cases, she suggested.  

This resource only includes data for a 25-year period from Jan. 1, 1990, to Dec. 31, 2014, for 13 regional Surveillance, Epidemiology and End Results (SEER) cancer registries. These spanned California, Connecticut, Hawaii, Iowa, New Jersey, New Mexico, Utah, Atlanta, Detroit and Seattle. The registries represent approximately 27.7% of the total U.S. Asian population and 47.2% of the Pacific Islander population.  

 In the study, authors reviewed 758,056 cancers of all types in non-Hispanic whites and 89,714 in members of American Asian, Native Hawaiian and other Pacific Islander populations.