YOUR HEALTH: TAKE CHARGE!
CANCER DISPARITIES AMONG AANHPI GROUPS
By: Warren Chin, MD
Cancer is the leading cause of death among Asians even though Asian Americans have lower overall cancer rates than non-Hispanic whites. Many serious disparities exist in Asian American, Native Hawaiian, and Pacific Islander (AANHPI) communities for certain types of cancer, cancer incidence, and mortality. Our communities also suffer needlessly from poorer health outcomes and higher cancer mortality, largely due to lower rates of cancer screening.
Cancer Incidence and Mortality
As a whole, Asian Americans suffer very high rates of cervical, breast, stomach, prostate, colorectal, and hepatitis-B related liver cancers. Vietnamese women have the highest rates of cervical cancer in the United States, and Chinese women have the highest mortality rate from breast cancer. Although AANHPI men and women have lower rates for common cancers, both AANHPI men and women are more likely to have stomach cancer and twice as likely to die from it. Both Asian American men and women suffer from a higher incidence and mortality rate from liver cancer than any other ethnic group in the United States.
High rates of smoking among Asian males contributes to higher rates of lung, esophageal, and laryngeal cancers; and the secondhand smoke in Asian households also contributes significantly to higher rates of cancer in nonsmoking family members. Lung cancer is a leading cause of death for Asian males and females and is highest among the Vietnamese.
The cancer burden is exceedingly high in the Native Hawaiian and Pacific Islander populations. Native Hawaiian women is the only group among all AANHPI groups who suffer from higher overall cancer incidence compared to non-Hispanic whites. Native Hawaiian men suffer from a higher lung cancer incidence than non-Hispanic white men. The overall cancer mortality is highest among Native Hawaiian and Samoan men and women, and even exceeds the overall cancer mortality rate for non-Hispanic white men and women. When compared to other Asian American subpopulations, Native Hawaiian and Samoan men and women have the highest overall cancer incidence and mortality rates due to high rates of prostate, lung, stomach, and colorectal cancer in men and breast and lung cancer among Native Hawaiian and Samoan women.
Cancer Screening Disparities
Although the cancer burden in AANHPI groups is very serious, Asians have the lowest screening rates for cancers of the colon and rectum, breast, cervix, and prostate of all ethnic groups in the United States. This can lead to later stages of diagnosis for several cancers and more unfavorable health outcomes.
Many factors may contribute to this disparity, including cultural differences, language barriers, education level, and access to health information. Because cultural factors may contribute to this disparity, culturally specific interventions are necessary to determine successful health interventions, increase screening rates, and improve health outcomes. It is important to monitor AANHPI groups separately to address them with appropriate cancer control interventions.
Cancer Screening and You
It is very important to know what cancers you should be screened for. The following list includes cancer screening adapted from the American Cancer Society.
- Get screened for Hepatitis B. 1 in 4 patients with chronic hepatitis B will die from liver cancer or liver failure, and chronic infections stay in the body even if symptoms rarely show
- Yearly mammograms starting at age 40
- Clinical breast exam every 3 years for women aged 20-30 and every year for women aged 40+
Colorectal cancer and polyps
- At age 50, men and women should test for polyps and cancer or for cancer only. Talk to your doctor about which test is best for you.
- All women should begin screening 3 years after having vaginal intercourse, but no later than 21 years old with regular Pap test every year.
- Women age 30 with 3 normal Pap test results in a row may get screened every 2 to 3 years. Women older than 30 may get screened every 3 years with the additional Human Papilloma virus (HPV) test.
- At age 70 or older, women with 3 or more normal Pap tests in a row or no abnormal Pap test results in the last 10 years may stop having Pap tests.
- Women with total removal of the uterus and cervix may stop having Pap tests, unless reason for surgery was for cervical cancer or pre-cancer. Women with uterus only removal should continue to have Pap tests.
- Starting at age 50, all men should talk to their doctors about testing to decide if it is the right choice to take the PSA blood test with or without a rectal exam.
For more information on cancer screening, talk to your physician or visit: American Cancer Society
BUILDING YOUR HIV/AIDS AWARENESS
By: Ho Luong Tran, MD, MPH
May is National Asian & Pacific Islander Heritage Month, a month to commemorate the achievements, celebrate the culture, and recognize the essential contributions that AANHPI bring to this country's identity, history, and future. It is also a time to raise much needed awareness on the health disparities affecting the AANHPI community. One disease that disparately impacts AANHPI is HIV/AIDS, and this May 19th marks National Asian & Pacific Islander HIV/AIDS Awareness Day.
Fast Facts about HIV/AIDS
- HIV stands for 'human immunodeficiency virus'. The virus weakens the immune system, which is needed to stave off infections.
- AIDS stands for 'acquired immunodeficiency syndrome'. It is a definition based on the symptoms, infections, and cancers that occur after HIV has weakened the immune system.
- The period an HIV infection developing AIDS can vary, from 5 to 15 years.
- While some persons develop symptoms similar to fever and/or joint pain, most people newly infected with HIV do not know it.
- HIV/AIDS is highly infectious, but also highly preventable – there are only 3 basic ways to become infected, or infect others and they are:
- Vaginal or anal intercourse with someone HIV/AIDS positive
- Blood exchange (i.e. sharing needles with someone who is HIV/AIDS positive)
- An HIV/AIDS positive mother may give birth to a child who is HIV positive.
HIV/AIDS AWARENESS IN AANHPI COMMUNITIES
National Asian & Pacific Islander HIV/AIDS Awareness Day, was developed by the Banyan Tree Project, a partnership of the Asian Pacific Islander Wellness Center. According to the Banyan Tree Project:
- 1 in 3 Asians and Pacific Islanders living with HIV don't know it
- Over half of Pacific Islanders have never been tested for HIV
- Over two-thirds of Asians have never been tested for HIV
Only AANHPI, according to a Centers for Disease Control (CDC) report, show a significant increase in the percentage of HIV/AIDS cases. If left unchecked, the rate of AANHPI living with HIV/AIDS will exceed those of Latinos in five years and African Americans in ten. Additional CDC data shows:
- The number of APIs living with AIDS has climbed by more than 10 percent in each of the last 5 years;
- 67% of API men living with HIV/AIDS in 2005 are men who have had sex with other men;
- Over 25% of AANHPI living with HIV/AIDS are women.
Why the increase?
AANHPI include large segments of the population who are Limited English Proficient (LEP), high immigrant populations, and who have greatly varying degrees of health awareness on the subject. HIV/AIDS related stigma is another unique barrier faced by AANHPI. Taboos related to sexual behavior, sexual orientation, and gender identity prevent many AANHPI men and women from getting tested. These barriers contribute to low testing rates for AANHPIs.
What You can Do
The only way to help yourself and others is to know your HIV/AIDS status through testing. NCAPIP recommends that all sexually active individuals, regardless of gender or ethnicity, get tested for HIV/AIDS:
- Consult with your doctor about an HIV/AIDS test and for more information. Ask your doctor to provide you with local sites to get tested.
- You can also visit http://www.hivtest.org/ for local test sites in your area.
- Get tested. All test results are confidential.
If you have a positive diagnosis for HIV/AIDS, it is not the end of the world: there are treatments available and you should talk to your doctor about them. The earlier the detection, the better. Early detection is key to living a healthy life as well as protecting your partner.
In the case that you are HIV negative, stay that way by:
- Practicing safe sex (i.e., condom use)
- Know your partner, and make sure they have been screened, too.
HIV/AIDS is serious, and it is important for all of us to understand and confront it for the good of ourselves, our partners, and our communities. As always, consult with your physician on all matters related to your health, and be safe.