The percentage increase in Asian Americans who are dying of cancer is growing faster than for any other ethnic group. And cancer is the leading cause of death in Asian American women, the only population group in the U.S for which this is true, according to the Intercultural Cancer Council (ICC).
To help reduce the incidence of cancer in Asian American communities, the National Cancer Institute has awarded the UC San Francisco Comprehensive Cancer Center and five other cancer centers in the U.S. a $7.6 million grant for a five year study called Asian American Network for Cancer Awareness, Research and Training. UCSF will receive $676,000 spread out over the course of the study, said Stephen McPhee, MD, professor of medicine and principal investigator for the study at UCSF.
UCSF already does community outreach and education to local Vietnamese women about breast and cervical cancer screening, McPhee said. Cervical cancer occurs five times more often in Vietnamese-American women than in Caucasian women, according to the ICC. UCSF researchers also conduct smoking cessation workshops for Vietnamese men. About 35 percent of Vietnamese men in California smoke, McPhee said. Researchers also work to immunize Vietnamese children against hepatitis B, a leading cause of liver cancer.
"I think the exciting part for us is that we've been working for the last 14 years with the Vietnamese community doing cancer awareness research and training activities. Now we have the chance to work with nine other Asian ethnicities in the Bay Area for the first time. This is a chance for us to take what we have learned by working with one Asian ethnicity and see how it applies or doesn't apply to other groups, both in terms of needs assessment and intervention," McPhee said.
As part of the study, UCSF researchers will target East Asian Indians, Cambodians, Chinese, Koreans, Hmong, Japanese, Thais, Laotians and Filipinos, as well as continuing to work with Vietnamese.
Ohio State University Comprehensive Cancer Center will lead this first-ever national effort to cut cancer rates among Asian Americans, a diverse population encompassing more than 30 different ethnic groups and 800 different languages and dialects. During the five-year period, the study will develop cancer awareness and prevention programs targeted to specific groups of Asian Americans. It also seeks to increase the number of Asians participating in clinical and prevention trials, train Asian American health workers in cancer prevention, and develop grant-funded research by new Asian investigators. In addition, the grant will help researchers study why the medical outcomes for Asian Americans with cancer are often worse than the outcomes for Caucasians.
"It's not just increased incidence and prevalence of cancers like cervical and liver cancer, but also disparities in outcomes from other cancers that concerns us," McPhee said. "So that even though breast cancer may be less common in some Asian ethnicities, when it is detected these women often have worse outcomes."
The researchers also will address why these groups often do not get preventive screening for early detection of cancers that hit Asian Americans the hardest. For example, liver cancer is the number three cancer killer in Asian Americans. It is frequently caused by hepatitis B, for which there is an effective vaccine. Also, cervical cancer deaths among Vietnamese women could be reduced through wider use of Pap smear tests.
"Some cancers, like cervical cancer, are remarkably more common in these populations than in the American population in general," McPhee said. "The lack of screening for such cancers may be related to limited access and to cost. It may be language. Imagine if you spoke only Vietnamese and you needed a mammogram, but it had to be done at a place where no one spoke your language and where there was no interpreter to help. It would be very difficult, if not impossible, to make your appointment, to understand what the test involved and to follow instructions."
The other centers involved in the Asian American Network for Cancer Awareness, Research and Training study are Dana-Farber Cancer Institute (Harvard University, Boston), Herbert Irving Comprehensive Cancer Center (Columbia University, New York City), Fred Hutchinson Cancer Research Center (University of Washington, Seattle) and Jonsson Comprehensive Cancer Center (University of California, Los Angeles.) Nearly half of all Asian Americans in the U. S. live in the cities in which these centers are located.