Abstract
Background
South Asian immigrants living in the United Kingdom and Canada have been found to have lower rates of cancers of all types compared with the native born population and most other immigrant groups. Cancer among Asian Indian/Pakistani people in the United States has been studied very little.
Methods
Incidence rates for all cancers combined and site-specific rates for major cancers were estimated for Asian Indians/Pakistani population using incidence data from the U.S. National Cancer Institutes SEER database and population data from the U.S. Census Bureau. Site-specific survival was compared for major cancer sites between Asian Indians/Pakistanis and Caucasians using Cox proportional hazards models.
Results
Cancer rates for Asian Indian/Pakistani males and females were considerably lower than for White Americans with standardized incidence ratios (SIRs) of 0.46 (95% CI = 0.44, 0.48), and 0.55 (95% CI = 0.53, 0.58) respectively. Site-specific rates were lower for both genders for most sites with particularly low rates observed for lung, colorectal, female breast, and prostate cancer. Among common cancers sites, survival was generally better among Asian Indians/Pakistanis than Caucasians with the notable exception of breast cancer for which Caucasians had slightly better survival.
Conclusions
The finding that Asian Indians/Pakistanis in the United States have relatively low incidence rates for most major cancers is consistent with studies from other countries. Whether the low incidence of cancer and above average cancer survival for this group is related to their well-above average socioeconomic status or cultural and behavioral factors is a topic for further research.
Similar content being viewed by others
References
Jain RV, Mills PL, Parikh-Patel A (2005) Cancer incidence in the south Asian population of California 1988–2000. J Carcinog 4:21. doi:10.1186/1477-3163-4-21
Winter H, Cheng KK, Cummins C, Maric R, Silcocks P, Varghese C (1999) Cancer incidence in the south Asian population of the U.K. (1990–1992). Br J Cancer 79:645–654. doi:10.1038/sj.bjc.6690102
Sheth T, Nair C, Nargundkar M, Anand S, Yusuf S (1999) Cardiovascular and cancer mortality among Canadians of European, south Asian and Chinese origin from 1979 to 1993: an analysis of 1.2 million deaths. CMAJ 161:132–138
Singapore Cancer Registry report No. 6: Trends in cancer incidence in Singapore: 1968–2002. www.hpb.gov.sg/data/hpb.home/files/edu/Report_1968_2002.pdf. Accessed 5 July, 2007
The second report of the National Cancer Registry: Cancer Incidence in Malaysia. www.crc.gov.my/publications/documents/Report/NCR2ndReport.pdf. Accessed 5 July, 2007
Li CI, Malone KE, Daling JR (2003) Differences in breast cancer stage, treatment, and survival by race and ethnicity. Arch Intern Med 163:49–56. doi:10.1001/archinte.163.1.49
Farooq S, Coleman MP (2005) Breast cancer survival in South Asian women in England and Wales. J Epidemiol Community Health 59:402–406. doi:10.1136/jech.2004.030965
Dos Santos Silva I, Mangtani P, De Stavola BL, Bell J, Quinn M, Mayer D (2003) Survival from breast cancer among South Asian and non-South Asian women resident in South East England. Br J Cancer 89(3):508–512. doi:10.1038/sj.bjc.6601097
Velikova G, Booth L, Johnston C, Forman D, Selby P (2004) Breast cancer outcomes in South Asian population of West Yorkshire. Br J Cancer 90(10):1926–1932. doi:10.1038/sj.bjc.6601795
Chien C, Morimoto LM, Tom J, Li CI (2005) Differences in colorectal carcinoma stage and survival by race and ethnicity. Cancer 104(3):629–639. doi:10.1002/cncr.21204
Breslow NE, Day NE (1987) Statistical Methods in Cancer Research: Volume II—the design and analysis of cohort studies. IARC Scientific Publications No. 82
Silcocks P (1994) Estimating confidence limits on a standardised mortality ratio when the expected number is not error free. J Epidemiol Community Health 48:313–317
Parkin DM, Whelan SL, Ferlay J, Storm H (2005) Cancer incidence in five continents, vol I to VIII. IARC CancerBase No. 7, Lyon
Therneau TM, Grambsch PM, Fleming TR (1990) Martingale-based residuals for survival models. Biometrika 77:147–169. doi:10.1093/biomet/77.1.147
Wu TY, West B, Chen YW, Hergert C (2006) Health beliefs and practices related to breast cancer screening in Filipino, Chinese and Asian-Indian women. Cancer Detect Prev 30:58–66. doi:10.1016/j.cdp.2005.06.013
Kagawa-Singer M, Pourat N (2000) Asian American and Pacific Islander breast and cervical carcinoma screening rates and Healthy People 2000 objectives. Cancer 89:696–705. doi :10.1002/1097-0142(20000801)89:3<696::AID-CNCR27>3.0.CO;2-7
Pierre Cuneo, Ethnic minorities economic performance: Surveying literature to emphasise facts, analysis and likely patterns for the future. April 2001 U.K. Cabinet Office Performance and Innovation Unit. www.cabinetoffice.gov.uk/strategy/downloads/files/ethnic.pdf. Accessed 2 July, 2007
CDC (2004) Prevalence of cigarette use among 14 racial/ethnic populations—United States 1999–2001. MMWR, Morb Mortal Wkly Rep 53(03):49–52
Siemiatycki J, Krewski D, Franco E, Kaiserman M (1995) Associations between cigarette smoking and each of 21 types of cancer: a multi-site case-control study. Int J Epidemiol 24(3):504–514. doi:10.1093/ije/24.3.504
Bryant A, Cerfolio RJ (2007) Differences in epidemiology, histology, and survival between cigarette smokers and never-smokers who develop non-small cell lung cancer. Chest 132(1):185–192. doi:10.1378/chest.07-0442
Sundelof M, Lagergren J, Ye W (2008) Patient demographics and lifestyle factors influencing long-term survival of oesophageal cancer and gastric cardiac cancer in a nationwide study in Sweden. Eur J Cancer 44(11):1566–1571. doi:10.1016/j.ejca.2008.04.002
Jonnalagadda SS, Diwan S, Cohen DL (2005) U.S. Food Guide Pyramid food group intake by Asian Indian immigrants in the U.S. J Nutr Health Aging 9(4):226–231
Dos Santos Silva I, Mangtani P, McCormack V, Bhakta D, McMichael AJ, Sevak L (2004) Phyto-estrogen intake and breast cancer risk in South Asian women in England: findings from a population-based case-control study. Cancer Causes Control 15:805–818. doi:10.1023/B:CACO.0000043431.85706.d8
Surh YJ, Chun KS (2007) Cancer chemopreventive effects of curcumin. Adv Exp Med Biol 595:149–172. doi:10.1007/978-0-387-46401-5_5
Tayyem RF, Heath DD, Al-Delaimy WK, Rock CL (2006) Curcumin content of tumeric and curry powders. Nutr Cancer 55(2):126–131. doi:10.1207/s15327914nc5502_2
Mohanty SA, Woolhandler S, Himmelstein DU, Bor DH (2005) Diabetes and cardiovascular disease among Asian Indians in the United States. J Gen Intern Med 20(5):474–478. doi:10.1111/j.1525-1497.2005.40294.x
Cavalli-Sforza LL (2000) Genes people and languages. University of California Press, California
U.S. Census Bureau’s American Factfinder Fact sheets for race, ethnic or ancestry group. http://factfinder.census.gov/servlet/SAFFFactsCharIteration?_submenuId=factsheet_2&_sse=on. Accessed 3 July, 2007
U.S. Census Bureau’s American Factfinder Census Summary File 4. http://factfinder.census.gov/servlet/DTGeoSearchByListServlet?ds_name=DEC_2000_SF4_U&_lang=en&_ts=243817643062. Accessed 31 Oct, 2008
U.S. Census Bureau’s American Factfinder Census Summary File 4. http://factfinder.census.gov/servlet/DTGeoSearchByListServlet?ds_name=DEC_2000_SF4_U&_lang=en&_ts=201676568406. Accessed 3 July, 2007
Acknowledgments
The authors would like to thank the reviewer whose comments greatly improved the quality of the manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Goggins, W.B., Wong, G. Cancer among Asian Indians/Pakistanis living in the United States: low incidence and generally above average survival. Cancer Causes Control 20, 635–643 (2009). https://doi.org/10.1007/s10552-008-9275-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10552-008-9275-x