Incidence of Lung Cancer Among Never-Smoking Asian American, Native Hawaiian, and Pacific Islander Females

DeRouen, Mindy C.; Canchola, Alison J.; Thompson, Caroline A.; Jin, Anqi; Nie, Sixiang; Wong, Carmen P.; Lichtensztajn, Daphne Y.; Allen, Laura; Patel, Manali I.; Daida, Yihe G.; Luft, Harold S.; Shariff‐Marco, Salma; Reynolds, Peggy; Wakelee, Heather A.; Liang, Su‐Ying; Waitzfelder, Beth E.; Cheng, Iona; Gomez, Scarlett Lin

doi:10.1093/jnci/djab143

Cited by 29 publications

(31 citation statements)

References 42 publications

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“…It is becoming clear, however, that among patients with lung cancer, those who have never smoked have distinct characteristics when compared to those who have smoked in their lifetime. Among patients who have never smoked, females have been found to have higher rates of lung cancer than their male counterparts, and this is especially pronounced among Asian patients (6)(7)(8)(9)(10)(11)(12)(13)(14). Patients who have never smoked have also been found to have higher likelihood of adenocarcinoma than those who have ever smoked (7)(8)(9)11,15,16).…”

Section: Introductionmentioning

confidence: 99%

Sociodemographic and clinical characteristics associated with never-smoking status in patients with lung cancer: findings from a large integrated health system

Banks¹,

Sumner²,

Alabaster³

et al. 2022

Transl Cancer Res TCR

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Background: Evidence is limited characterizing sociodemographically diverse patient populations with lung cancer in relation to smoking status.Methods: In a cross-sectional analysis of adults diagnosed with lung cancer at ages ≥30 years from 2007-2018 within an integrated healthcare system, overall and sex-specific prevalence of never smoking were estimated according to sociodemographic and clinical characteristics. Adjusted prevalence ratio (aPR) and 95% confidence interval (CI) were also estimated using modified Poisson regression to identify patient characteristics associated with never smoking, overall and by sex. Similar analyses were conducted to explore whether prevalence and association patterns differed between non-Hispanic White and Asian/Pacific Islander patients.

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Section: Introductionmentioning

confidence: 99%

Sociodemographic and clinical characteristics associated with never-smoking status in patients with lung cancer: findings from a large integrated health system

Banks¹,

Sumner²,

Alabaster³

et al. 2022

Transl Cancer Res TCR

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“…Among Asian Americans, there can be negative effects on mental and physical health ( 40 , 41 ). When health statistics are disaggregated by Asian subgroups and differences in cancer burden are described ( 42 , 43 ), the evidence points to considerable health disparities ( 44-46 ). The consequences perpetuated by aggregated data (which masks the within-group differences) and societal indifference lead to “invisibilization” or the intentional omission of Asian Americans ( 37 ) and especially the exclusions of Asian Americans in biomedical, behavioral, psychosocial, or other health research and funding ( 47 , 48 ).…”

Section: Model Minority Myth and Asian Americans’ Cancer Burden: Uniq...mentioning

confidence: 99%

“…Another unusual example of a uniquely high Asian American cancer burden is lung cancer among never smokers, particularly Asian Americans women ( 43 ). Never-smoking Chinese American women have the highest age-adjusted lung cancer incidence rate (22.8/100 000, 95% CI = 17.3 to 29.1) compared with never-smoking non-Hispanic White women (10.1/100 000, 95% CI = 9.0 to 11.6).…”

Section: Model Minority Myth and Asian Americans’ Cancer Burden: Uniq...mentioning

confidence: 99%

“…Never-smoking Chinese American women have the highest age-adjusted lung cancer incidence rate (22.8/100 000, 95% CI = 17.3 to 29.1) compared with never-smoking non-Hispanic White women (10.1/100 000, 95% CI = 9.0 to 11.6). Although the age-adjusted lung cancer incidence rate among never-smoking Asian American men is lower at 16.8 in 100 000 (95% CI = 9.3 to 26.5), it is double the rate among non-Hispanic White men at 8.2 (95% CI = 6.8 to 9.7) ( 43 ). More than one-half of Asian American women with lung cancer have never smoked, and this proportion is as high as 88% among Chinese American women with lung cancer ( 43 ).…”

Section: Model Minority Myth and Asian Americans’ Cancer Burden: Uniq...mentioning

confidence: 99%

“…Although the age-adjusted lung cancer incidence rate among never-smoking Asian American men is lower at 16.8 in 100 000 (95% CI = 9.3 to 26.5), it is double the rate among non-Hispanic White men at 8.2 (95% CI = 6.8 to 9.7) ( 43 ). More than one-half of Asian American women with lung cancer have never smoked, and this proportion is as high as 88% among Chinese American women with lung cancer ( 43 ).…”

Section: Model Minority Myth and Asian Americans’ Cancer Burden: Uniq...mentioning

confidence: 99%

See 2 more Smart Citations

Charting a Path Towards Asian American Cancer Health Equity: A Way Forward

Chen

Lee

Madan

et al. 2022

JNCI: Journal of the National Cancer Institute

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On July 29, 2021, the US Food and Drug Administration’s Oncology Center of Excellence convened Conversations on Cancer. This Conversation, the first ever by the US Food and Drug Administration, focused on Asian Americans and served as the platform for this Commentary. Panelists elaborated on topics ranging from heterogeneity in Asian American demographics to racism through a path to health equity and supplemented this Commentary with literature citations. Asian Americans are the fastest-growing US race group, yet data aggregation obscures distinctions and cancer disparities within the more than 24 million Asians living in the United States with harmful impacts on communities and patients, as illustrated by breast cancer survivor Susan Shinagawa’s patient-to-advocate journey. Bigotry against Asian Americans has been pervasive since the 19th century, but especially during the COVID-19 pandemic. Asian Americans are unique as the first US population to experience cancer as the leading cause of death. Asian Americans are disproportionately affected by cancers because of infectious origins and have the highest rates of lung cancer among never-smoking women. The infinitesimal proportion of the National Institutes of Health’s budget compared with experiencing the highest percentage increases of any US racial population more than 3 decades highlights the dearth of focused research among Asian Americans. Recognizing the heterogeneity of Asian Americans and that disaggregated data are critical for accurately characterizing distinct ethnic groups, focusing on the impact of racism and COVID-19 on cancer disparities, and focusing and prioritizing funding resources are necessary steps forward for achieving health equity for Asian Americans.

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Incidence of Lung Adenocarcinoma by Age, Sex, and Smoking Status in Taiwan

Chien,

Jiang,

Tsai

et al. 2023

JAMA Netw Open

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ImportanceKnowing whether the effects of smoking and other risk factors with lung adenocarcinoma (ADC) incidence varies by sex would provide information on lung cancer prevention strategies.ObjectiveTo evaluate whether women in Taiwan have higher age- and tumor stage–specific lung ADC incidence rates than men irrespective of smoking status (ie, ever smoker or never smoker).Design, Setting, and ParticipantsThis population-based cohort study used data sets synthesized from the Taiwan Cancer Registry (TCR) from 1979 to 2019; the TCR Long Form (TCRLF) from 2011 to 2019, which provides individual-level smoking and tumor stage information; the Taiwan Cause of Death Database (TCOD) from 1985 to 2019; the National Health Insurance Research Database (NHIRD) from 2000 to 2020; the Monthly Bulletin of Interior Statistics (MBIS) from 2011 to 2019; the National Health Interview Survey from 2001, 2005, 2009, 2013, and 2017; and Taiwan Biobank data from 2008 to 2021. Included patients were aged 40 to 84 years and had any invasive lung cancer from January 1, 2011, to December 31, 2019.ExposureSmoking status.Main Outcomes and MeasuresThe main outcomes were age-specific female-to-male incidence rate ratios (IRRs) of lung ADC by smoking status and tumor stage. Linked data from the TCR, TCOD, NHIRD, Taiwan National Health Interview Survey, and MBIS were used to estimate the age- and sex-specific numbers of cancer-free individuals at midyears from 2011 to 2019 by smoking status. Using the TCR and TCRLF, age-, sex-, tumor stage–, and diagnosis year–specific numbers of patients with lung ADC from 2011 to 2019 by smoking status were estimated.ResultsA total of 61 285 patients (32 599 women [53.2%]) aged 40 to 84 years (mean [SD] age, 64.66 [10.79] years) in the Taiwanese population of approximately 23 million were diagnosed with invasive lung ADC as their first lifetime cancer between 2011 and 2019. Among smokers, men had higher tobacco use by almost all examined metrics, including nearly twice the mean (SD) number of pack-years smoked (eg, 7.87 [8.30] for men aged 30-34 years vs 4.38 [5.27] for women aged 30-34 years). For 5-year age bands between 40 and 84 years, incidence of lung ADC was significantly higher among females than males for nearly all age groups irrespective of tumor stage and smoking status (eg, for the age group 70-74 years, the female-to-male IRR for late-stage lung ADC among never smokers was 1.38 [95% CI, 1.30-1.50]).Conclusions and RelevanceIn this cohort study, women had higher age- and stage-specific lung ADC incidence rates than men in Taiwan for both never and ever smokers, suggesting the possibility of differential exposures between sexes to risk factors other than smoking and the potential modification of ADC risk factors by sex. Further work is needed to determine whether this pattern replicates in other populations, discover the causes of lung ADC, and put preventive measures in place.

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Incidence of Lung Cancer Among Never-Smoking Asian American, Native Hawaiian, and Pacific Islander Females

Cited by 29 publications

References 42 publications

Sociodemographic and clinical characteristics associated with never-smoking status in patients with lung cancer: findings from a large integrated health system

Sociodemographic and clinical characteristics associated with never-smoking status in patients with lung cancer: findings from a large integrated health system

Charting a Path Towards Asian American Cancer Health Equity: A Way Forward

Incidence of Lung Adenocarcinoma by Age, Sex, and Smoking Status in Taiwan

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