Title: Analysis of Colorectal and Cervical Cancer Disparities and Trends Among Disaggregated Asian Ethnic Subgroups
Abstract
Asian Americans are the only racial/ethnic group in the United States for whom cancer is the leading cause of death, with the majority of Asian American ethnic subgroups having colorectal cancer (CRC) as the leading cause of cancer. Disaggregation of the “Asian American category” highlights significant heterogeneity in the incidence of CRC, with incidence rates ranging from 34.7-57.5 per 100,000 within subgroups. Data from the California Cancer Registry (CCR) reports that Vietnamese and Korean women have higher incidence of cervical cancer when compared to non-Hispanic white women. This work has been expanded to include five registry areas in the United States (U.S.), and has found similar results. However, disaggregated Asian subgroup analyses have yet to be completed on the national level for cervical & CRC outcomes – two pertinent screening preventable cancers.
Heterogeneity in the incidence of CRC and cervical cancer suggests that investigating incidence rates within disaggregated Asian subgroups at a larger scale will allow researchers to better identify groups at the highest risk for these cancers nationally, supporting the development of targeted preventative interventions. Research suggests that differences in screening and the Yost Index can contribute to disparities in incidence between racial groups. The Yost index is a composite index representing socioeconomic status. Differences in variables incorporated by the Yost Index persist between Asian subgroups and may serve as a possible explanation for the hypothesized difference in incidence rates between Asian subgroups.
Consequently, my dissertation project aims to (1) Determine and characterize trends in incidence rates of colorectal and cervical cancer stratified by Asian ethnic groups using disaggregated case data from the SEER database, across the years 2000-2022; (2) Investigate effect modification by the Yost Index in the relationship between disaggregated Asian ethnic groups and colorectal and cervical cancer incidence in the SEER database; and (3) Investigate how behavioral factors, such as cancer screening, differ between disaggregated Asian ethnic groups using data from the BRFSS, across the years 2000-2022.
This project will use two nationally representative data sources to carry forth the aims of this study: the Surveillance, Epidemiology, and End Results (SEER) program Research Plus Incidence data, and data from the Behavioral Risk Factor Surveillance System (BRFSS) and will facilitate the investigation of CRC and cervical cancer incidence in disaggregated Asian subgroups at a national scale. This project is currently at the concept proposal stage.
