Abstract
Introduction: There is a critical need to address cancer health disparities among Native Hawaiians and Pacific Islanders (NHPI)'a disparity that continues to unveil itself as data are disaggregated from Asian Americans, who generally have lower cancer rates. NHPIs are 30% more likely to be diagnosed with cancer as compared to Non-Hispanic Whites. Late stage diagnosis and death due to cancer is disproportionately experienced by NHPI compared to other ethnic groups in the US. Breast, cervical, stomach, and lung cancer are high among NHPI women. Among men, Samoans suffer 8 times the rate of liver cancer and 5 times the rate of stomach cancer compared to non-Hispanic Whites. Native Hawaiian men are also twice as likely to be diagnosed with both stomach cancer and liver cancer. Factors contributing to poor health outcomes include cultural barriers, poor nutrition, lifestyle, and high rates of obesity.
Methods: Data from the 2009 California Health Interview Survey (CHIS) was used to examine breast and colon cancer screening, smoking, binge drinking, and eating behaviors among NHPI over 40 years of age compared across race and ethnic subgroups.
Results: Sample size included 57 NHPI, 3,315 Latinos, 3,583 Asians, 1,580 African Americans, and 27,781 Non-Hispanic Whites. NHPI women who reported ever having a mammogram (91.9%) had lower rates compared to African Americans and Non-Hispanic Whites (94.7% and 95.7%, respectively; p<0.01). The proportion of NHPIs that screened within the last 2 years did not differ compared to other ethnic groups. NHPIs reported less screening for colon cancer (stool test 49.1%, colonoscopy 36.8%, and sigmoidoscopy 14.0%) compared to Non-Hispanic Whites (53.5%, 53.6%, and 32.3%; all p<0.0001), although higher than Latinos (33.2%, 30.4%, and 13.3%; all p<0.01). Notably, NHPIs report the highest rates of current smoking (19.3%) compared to Non-Hispanic Whites (10.7%, p=0.01) and Asians (8.3%, p<0.001), though not statistically different from African Americans (16.7%). Binge drinking is highest for NHPI (26.3%) compared to all ethnic groups (p<0.05). Reported fruit and vegetable intake were low (mean = 7.4 fruits and 6.9 vegetables per week), while fast food and soda consumption were high for NHPI (mean = 1.4 times ate fast food in last week and 1.2 times drinking soda per week) with differences across ethnic groups (p<0.0001).
Conclusions: Many risk factors linked to cancer are highest among NHPIs, whose population has increased by 40% between 2000 and 2010. The importance of keeping NHPI data disaggregated to understand specific risk factors is further demonstrated and the need to address cancer health disparities is urgent.
Citation Format: Christina K. Holub, Maria Rosario Araneta, Dayana Chanson. Adult Pacific Islanders in California: Comparing cancer screening behaviors, lifestyle, and nutrition to non-Hispanic whites and other minority subgroups. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr A80.