Abstract

Background Asian Americans (AA) are the fastest growing ethnic group in the US with high proportions of immigrants. Nativity is important as cancer risk factors vary by country. We sought to understand differences in cancer mortality among AAs by nativity (foreign-born vs. US-born). Methods 98,826 AA (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) decedents with cancer-related deaths from US death certificates (2008-2017) were analyzed. Thirteen cancers that contribute significantly to AA cancer mortality were selected and categorized by etiology: tobacco-related, screen-detected, diet/obesity-related, and infection-related. 10-year age-adjusted mortality rates [AAMR (95% CI); per 100,00] and standardized mortality ratios [SMR (95% CI)] using foreign-born as the reference group were calculated. Results Overall, foreign-born AAs had higher mortality rates than US-born. Japanese US-born males had the highest tobacco-related mortality rates (Foreign-born AAMR: 43.02 [38.72, 47.31], US-born AAMR: 55.38 [53.05, 57.72]). Screen-detected death rates were higher for foreign-born than US-born, except for among Japanese males [SMR 1.28 (1.21-1.35)]. Diet/obesity-related AAMRs were higher among females than males and highest among foreign-born females. Foreign-born males and females had higher infection-related AAMRs than US-born; the highest rates were foreign-born males: Korean (AAMR 41.54 [39.54, 43.53]) and Vietnamese (AAMR 41.39 [39.68, 43.09]). Conclusions We observed substantial heterogeneity in mortality rates across AA groups and by nativity. Contrary to the Healthy Immigrant Effect, most foreign-born Asians were dying at higher rates than US-born AAs. Impact: Disaggregated analysis of AA cancers, targeted and culturally tailored cancer screening, and treatments for infections among foreign-born Asians is critical for cancer prevention efforts.

View details for DOI 10.1158/1055-9965.EPI-21-0359

View details for PubMedID 34697057