International Journal of Epidemiology
Volume 30, Issue 5, 2001, Pages 976-982

Asian breast cancer survival in the US: A comparison between Asian immigrants, US-born Asian Americans and Caucasians (Article) (Open Access)

Pineda M.D. , White E.* , Kristal A.R. , Taylor V.
  • a Cancer Prevention Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, United States
  • b Cancer Prevention Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, United States, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195, United States, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109-1024, United States
  • c Cancer Prevention Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, United States, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195, United States
  • d Cancer Prevention Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109-1024, United States, Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98195, United States

Abstract

Background. This study examines whether acculturation of Asian American women, assessed by place of birth, is associated with survival after diagnosis of breast cancer. We hypothesized that environmental factors associated with acculturation, such as a high-fat diet, would result in a pattern of better survival for first-generation Asians compared with subsequent-generation Asian Americans. Methods. Analyses compare survival among women of four ethnic groups (Chinese [n = 1842], Japanese [n = 3319], Filipino [n = 1598] and a random sample of Caucasians [n = 10 000]) who were diagnosed with primary invasive breast carcinoma in three Surveillance, Epidemiology, and End Results Program (SEER) regions (San Francisco/Oakland, Hawaii, Seattle/Puget Sound) between 1973 and 1994. Analyses by birthplace compare first-generation Asian immigrants with subsequent-generation Asian Americans of the same ethnicity. Analyses were based on the Cox proportional hazards model and adjusted for age at diagnosis, stage of disease, year of diagnosis, type of treatment, marital status, and SEER region. Results. Japanese women had significantly better survival than all other races, but there were no significant differences in survival between Chinese, Filipino, and Caucasian women. There were no significant differences in survival by place of birth within each Asian ethnic group, after adjustment for demographic characteristics, stage of disease, and treatment. Conclusion. The findings do not support the hypothesis that acculturation of Asian American women is associated with decreased breast cancer survival.

Author Keywords

Breast cancer survival Birthplace Ethnicity Asian Americans Acculturation

Index Keywords

birth immigrant Chinese breast cancer Asian Caucasian demography randomization race difference human cancer survival ethnic group controlled study priority journal cancer staging Aged cancer cancer epidemiology ethnology hypothesis marriage United States racial disparity lipid diet invasive carcinoma Japan environmental factor Acculturation Asian American female cultural factor Article major clinical study adult age cancer diagnosis Asian immigrant ethnicity disease association Philippines
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-0035158316&doi=10.1093%2fije%2f30.5.976&partnerID=40&md5=08a230d999564ad0c8e594a413152f62
DOI: 10.1093/ije/30.5.976
ISSN: 03005771
Cited by: 48
Original Language: English