Cancer incidence and mortality among Filipinos in the USA and the Philippines: Patterns and trends

Abstract

Background Filipino Americans are the second largest Asian-American ethnic group, comprising 3.4 million persons in 2010. This population has grown rapidly, nearly doubling in size from 2000 to 2010. With their varied migration patterns over time, sociodemographic diversity in the USA, and growing presence, this group is a significant Asian-American population in which to evaluate cancer incidence and mortality patterns. Methods Two decades (1990-2010) of incidence data from the NCI Surveillance, Epidemiology, and End Results (SEER) registry and population estimate data from the 1990, 2000, and 2010 US Census are used to calculate incidence rates and trends. Incidence rates from available registries in the Philippines, obtained from the Cancer Incidence in Five Continents database, are presented. US cancer mortality rates from 36 states (from 2003 to 2011) are also presented. All rates and 95 % confidence intervals (CI) are calculated as cases or deaths per 100,000 persons. Annual rates are presented as trends, determined using joinpoint regression models to identify distinct changes in trends. Results Overall, cancer rates are higher for males than females in both the USA and the Philippines. Among US Filipino males, the five most common cancer sites are (1) prostate, (2) lung and bronchus, (3) colon and rectum, (4) non-Hodgkin lymphomas (NHL), and (5) liver, while these sites among males in the Philippines are (1) lung and bronchus, (2) prostate, (3) colon and rectum, (4) liver, and (5) stomach. Among US Filipina females, the three most common sites are (1) breast, (2) colon and rectum, and (3) lung and bronchus, with thyroid and corpus uterus changing as the fourth and fifth most common sites across the time period; in contrast, these sites among females in the Philippines are (1) breast, (2) cervix uteri, (3) colon and rectum, (4) lung and bronchus, and (5) ovary in 1993-1997 and (1) breast, (2) colon and rectum, (3) lung and bronchus, (4) cervix uteri, and (5) corpus uteri in 2003-2007. With regard to cancer mortality, lung, colorectal, prostate, liver, and pancreatic cancers were the five sites contributing most to cancer-related deaths among Filipino males in the USA and Philippines, while lung, breast, colorectal, pancreatic, and ovarian cancers were the five most common sites of cancer-related deaths for females in both populations. Incidence of breast, lung, thyroid, kidney, and bladder cancers is increasing among US Filipinas, and incidence of kidney cancer is increasing among US Filipino males. Conclusions The incidence and mortality patterns and trends presented for Filipinos in this chapter provide data to support targeted areas for cancer prevention, such as obesity for reducing the risks of uterine, colorectal, and breast cancers, and smoking prevention and cessation for lung, kidney, oral cavity and pharyngeal, bladder, and pancreatic cancers. For those sites that demonstrate changing trends or dramatic differences between Filipinos in the USA and in the Philippines, further targeted studies can leverage these incidence patterns to elucidate environmental and modifiable risk factors.