A new study has revealed “stark” differences in cancer death rates between Asian patients and Native Hawaiian or Pacific Islander (NHPI) patients in the United States, according to researchers.
Since 2018, national death certificates have included a new racial classification system that separates NHPI patients from Asian patients. To assess differences between the groups, researchers looked at age-standardized US cancer mortality rates from 2018 through 2020.
The data showed that, compared with Asian patients, NHPI men had a 39% higher total cancer death rate, and NHPI women had a 73% higher total cancer death rate.
“We have shown the importance of disaggregating Asian and NHPI individuals, as these groups have disparate cancer mortality rates that are hidden when analyzed together,” the researchers wrote in the Journal of the National Cancer Institute.
For this study, the researchers evaluated National Center for Health Statistics data on cancer deaths in US adults aged 20 years or older from 2018 through 2020. There were about 597,000 cancer deaths in 2018; 598,000 in 2019; and 601,000 in 2020.
Black men had the highest cancer death rate among men, at 298.2 per 100,000. This was followed by White men (250.8), American Indian/Alaska Native (AI/AN) men (249.2), NHPI men (205.6), Latino men (177.2), and Asian men (147.9).
Black women had the highest cancer death rate among women, at 206.5 per 100,000. This was followed by NHPI women (192.1), AI/AN women (189.9), White women (183.0), Latina women (128.4), and Asian women (111.4).
Asian patients had the lowest cancer death rates across all age groups. NHPI patients had the highest cancer death rates among people aged 20 to 49 years.
According to the researchers, when NHPI patients are grouped with Asian patients, the trends revealed “largely reflect” Asian individuals and are not representative of NHPI individuals.
Compared with all other racial/ethnic groups, NHPI men had the highest death rates for stomach cancer. Compared with Asian men, NHPI men had significantly higher death rates for leukemia, multiple myeloma, immunoproliferative neoplasms, and cancers of the stomach, liver, lung, prostate, bladder, and kidney.
NHPI women had the largest number of cancer deaths overall from breast cancer. Compared with all other racial/ethnic groups, NHPI women had the highest death rates for non-Hodgkin lymphoma (NHL), leukemia, and cancers of the cervix, uterus, oral cavity/pharynx, stomach, and soft tissue including the heart.
Compared with Asian women, NHPI women had significantly higher death rates for leukemia, NHL, multiple myeloma, and cancers of the breast, cervix, uterus, lung, and soft tissue including the heart.
“The disaggregation of the NHPI and Asian populations reveals a stark difference in cancer mortality patterns, consistent with studies that have shown disparities in cancer survival,” the researchers wrote. “However, it is important to note that Asian and NHPI populations are each comprised of a diverse range of ethnic groups with vastly different health care outcomes and socioeconomic status. We were not able to further disaggregate these populations using the current dataset, though this is an important area for future research.”
Haque AT, Berrington de Gonzalez A, Chen Y, et al. Cancer mortality rates by racial/ethnic groups in the United States, 2018–2020. J Natl Cancer Inst. Published online April 19, 2023. doi:10.1093/jnci/djad069