Cancer health disparities among Indian and Pakistani immigrants in the United States

Abstract

BACKGROUND.Immigrants from India and Pakistan comprise about 1.5% of the total United States population. To the author' knowledge, this is the first study analyzing epidemiologic data on Indian and Pakistani patients with newly diagnosed cancer.METHODS. The Surveillance, Epidemiology, and End Results (SEER) database has reported cancer incidence from 1973 to 2003. Since 1988, the Indian and Pakistani population has been reported separately under race and ethnicity. Frequency and survival analyses with SEER data were performed, and descriptive parameters were calculated along with overall survival in common cancers.RESULTS. In total, 6889 cases were reported between 1988 and 2003, and those cases included 51% men and 49% women (P 5 .821). Among men, 30% of cases were prostate cancers, 10% of cases were lung cancers, and 9% of cases were colorectal cancers. Among women, 38% of cases were breast cancers, 15% of cases were genital cancers, and 7% of cases were colorectal cancers. When overall survival with common cancer was compared between immigrants and non-Hispanic whites in the United States, it was better among Indian and Pakistani immigrants.CONCLUSIONS. In a United States-based Indian and Pakistani population, prostate and breast cancers were the most common malignancies in men and women, respectively. This differed from the incidence in India and Pakistan, where oral cavity cancer in men and breast and cervical cancers in women were the most common. These immigrant cancer patients also had better survival. This change in demographics may be attributed to multiple factors, and the current data have implications on cancer screening and intervention.

Breast cancers in U.S. residing Indian-Pakistani versus non-Hispanic White women: comparative analysis of clinical-pathologic features, treatment, and survival

“…As is well documented, exogenous estrogens are associated with increased ER positive breast cancers [38, 39], and thus in a patient population who have less exogenous estrogen exposure, there could theoretically be a shift in the proportion of estrogen positive to negative tumors. Data on ethnic variability of birth control methods suggest that rate of birth control pill usage in Indians is very low compared to their white counterparts [38, 40-42]. …”

Survival Disparities in Bladder, Kidney, and Prostate Cancer in Asian-Indian & Pakistani Immigrants to the United States as Compared to Other US Ethnic Groups: A Surveillance, Epidemiology and End Result (SEER) 2011 Public Use Database Study

“…any of the original people of the Far East, Southeast Asia, or the Indian subcontinent" (Hossain et al, 2008). According to the year 2010 US census data, approximately 15 million Asians now reside in the US, 4.8% of the total USA population.…”

“…For example, prostate cancer in the Indian subcontinent in 2008 was only the 4th leading cancer in Pakistani and Indian men (4-6% of all cancers) according to the World Health Organization (Hossain et al, 2008;Jian et al, 2005), but was the most common cancer in US-AIP men (29% of cancers). Factors known to influence genitourinary cancer risk include diet (e.g.…”

Breast cancer as a global epidemic

“…For example, in India the most common cancer type among women is cervical; however, once these women migrate to the USA, breast cancer becomes the most common cancer [4]. Other studies evaluating breast cancer incidence in immigrants from lowresource or transitioning countries have shown similar changes [5][6][7].…”

“…As areas become more developed, breast cancer risk factors such as obesity, early menarche and decreased or late childbearing are becoming more prevalent [4,5]. As these numbers continue to increase, it is important to remember the limited resources and different cultural beliefs in these areas and the importance of designing a unique and effective approach to decreasing the developing breast cancer burden.…”