Proportionate cancer incidence in the Laotian population of California, 1988–2006

Abstract

When the Vietnam War ended in 1975, pro-US Laotians (including Lao, Mien, Khmu) were displaced and became refugees in their own native country. Thousands fled to refugee camps in nearby Thailand and were eventually relocated to several Western countries, including the US. A listing of 1,195 Laotian cancer cases were extracted from the California Cancer Registry for diagnosis years 1988-2006. Cancer cases with birthplace coded as "Laos" were included. Proportionate incidence ratios (PIRs) and associated 95% confidence intervals (CI) were calculated for 17 selected cancer sites. The total population of California (all race/ethnic groups combined) was used as the reference. Proportional occurrence of cancers varied by genders and by cancer sites. Laotians in California experienced statistically significantly elevated risks for cancer of the nasopharynx (PIR = 14.8; 95% CI = 10.5-20.1), liver (PIR = 12.6; 95% CI = 10.8-14.6), stomach (PIR = 3.1; 95% CI = 2.4-4.0), cervix (PIR = 1.9; 95% CI = 1.5-2.3), pancreas (PIR = 2.1; 95% CI = 1.5-2.8), oral cavity (PIR = 1.8; 95% CI = 1.4-2.3), lung and bronchus (PIR = 1.4; 95% CI = 1.2-1.7). As found for other Asian subgroups, Laotians, too, have statistically significantly reduced risks for colorectal (PIR = 0.8; 95% CI = 0.6-0.9), colon (PIR = 0.7; 95% CI 0.5-0.9), breast (PIR 0.7; 95% CI = 0.5-0.8), and prostate (PIR = 0.1; 95% CI = 0.0-0.2) cancers. The increased risk found for mostly non-Western types of cancers have implications for culturally responsive cancer control and intervention activities targeting the Laotian population.

Racial and ethnic disparities in nasopharyngeal cancer with an emphasis among Asian Americans

“…Therefore, the changing risk profile after immigration, including modification in diet and health behaviors (eg, decreased intake of salted fish or preserved food and reduced tobacco consumption) does not solely depends on the duration of immigration, while other cultural factors also play important roles 31,32 . For instance, tobacco use is considered a cultural norm and tradition in Laotians and they continued to have the highest smoking prevalence (52%‐72% in male and 11% in female) than other AAs such as Vietnamese (24% in male and 7.9% in female) and Filipinos (20.6% in male and 7.5% in female) 31,34 . In addition, Chewing betel quid (containing betel leaves, areca nut, slaked lime and tobacco), which alone accounts for a third of head and neck cancers, is a common practice among Laotian females 34 …”

“…31,32 For instance, tobacco use is considered a cultural norm and tradition in Laotians and they continued to have the highest smoking prevalence (52%-72% in male and 11% in female) than other AAs such as Vietnamese (24% in male and 7.9% in female) and Filipinos (20.6% in male and 7.5% in female). 31,34 In addition, Chewing betel quid (containing betel leaves, areca nut, slaked lime and tobacco), which alone accounts for a third of head and neck cancers, is a common practice among Laotian females. 34 The peak incidence age of Vietnamese and Laotians (50-59) was younger than other groups (60-69).…”

Knowledge and Behaviors Toward Hepatitis B and the Hepatitis B Vaccine in the Laotian Community in Minnesota

“…A study evaluating the cancer burden in a Californian Laotian community (excluding ethnically Hmong) found that liver cancer was the second most common cancer diagnosis, which was 13 times more common than in the general population [16]. In fact, the rate of liver cancer in Laotian males was higher than other Asians [8].…”

“…Although the Laotian immigration to the U.S. started more than three decades ago, there is a lack of population-based data on the Laotian population [16], with nearly all that has been documented coming from California. Despite the high incidence of HBV infection and liver cancer, little is known about Laotian immigrants’ knowledge and beliefs about hepatitis B.…”

Cancer Screening in Refugees and Immigrants: A Global Perspective

“…14 Some immigrant groups in the United States may have lower risk of colorectal cancer than nonimmigrant populations. 15 However, as with breast cancer, it is worth noting that immigrants in the United States have significantly lower rates of colorectal cancer screening compared with U.S.-born adults regardless of time since immigration. As with breast cancer screening, longer duration of residence has been shown to correlate with improved screening.…”