The Sacramento Bee reports that cancer rates for Asians are dropping, but there is still a lot of work to do - Click to visit http://www.sacbee.com/
Although
cancer remains the leading killer for some Asian Americans, fewer are
getting the disease or dying from it, researchers will announce in
Sacramento today.
Following nationwide trends, the state`s Asian
Americans are doing better at fending off cancer than the state`s other
three major ethnic/racial groups. Still, there are reasons for Asian
Americans to worry.
Vast disparities in cancer rates exist among
various Asian American groups, and the adoption of Western lifestyles
is heightening risk of cancer and other diseases in several Asian
American populations.
The findings are among those to be
presented today and Saturday by the Asian American Network for Cancer
Awareness, Research and Training, a group of more than 100 leading
Asian American cancer authorities from throughout the United States.
The
network is headquartered at the University of California, Davis, and
funded by an $8.5 million grant from the National Cancer Institute.
"The
outcome of cancer is not just related to the cancer cell, but the
interaction of the cancer cell and the person who has the cancer," said
Dr. Andy Von Eschenbach, director of the National Cancer Institute who
is in Sacramento for the AANCART meeting. "We need to be more effective
in serving different populations who have different needs."
California,
with 35 percent of the country`s Asian population, and several leading
cancer centers, provides an excellent laboratory to study cancer trends
in Asian Americans generally, he said.
Among the findings:
* The incidence of breast cancer in Asian Americans in California is rising faster than in any other major ethnic group.
*
Asian Americans in California smoke less on the whole than Californians
in general, but about a third of Korean and Vietnamese men smoke.
*
The percentage of Asian and Pacific Islander children in California who
are overweight, which can contribute to certain cancers, more than
doubled between 1994 and 2003 to 15 percent from 7 percent.
National
cancer experts said the data being presented in Sacramento provide the
most detailed picture yet of the cancer burden for Asian Americans.
Dr.
Moon S. Chen Jr., professor of public health sciences at UC Davis
School of Medicine and the principal investigator for AANCART, said the
cancer picture for Asian Americans is unique.
No other disease takes a greater toll on Asian American women, for example, than cancer.
Heart
disease is the leading cause of death for Asian American men and men
and women of all other ethnic and racial groups, he said.
Still, the overall cancer picture for Asian Americans is a relatively healthy one.
A
new analysis by the state Department of Health Services Cancer
Surveillance Section found that the cancer incidence among Asian
Americans dropped 5.9 percent and deaths from cancer dropped 16.3
percent from 1988 to 2001 - declines that were more rapid than those in
any other groups.
But variations among the very diverse Asian
populations in California told a more complicated story. Koreans saw
only a 0.2 percent drop in cancer incidence, and Filipinos experienced
a 2.5 percent increase in their cancer death rate.
In addition,
Asian Americans have a higher-than-average incidence of cancers caused
by infections such as human papilloma virus, or HPV, which can lead to
cervical cancer, and hepatitis B, which can lead to liver cancer.
Breast cancer, too, is on the rise among Asian American women in
California.
In many cases, Chen said, these cancers flourish
because of a lack of preventive care. Asian American women have the
lowest rates of Pap smears, to detect HPV, and mammograms, to detect
cellular changes in breast tissue, he said.
"Part of this is
cultural and part of it is language barriers," he said. Many Asian
American women, for example, believe they should not have a
gynecological exam before marriage.
Nationwide, cervical cancer
rates are 200 to 500 times greater for Asian American women than for
white women, said Ken Chu, chief of the disparities research branch at
the National Cancer Institute.
The barriers to care are
especially acute among Hmong refugees, said Norepaul Mouaryang, a
Lao-Hmong interpreter at the UC Davis Medical Center.
"I see
them at the second or third stage of the disease because they are so
scared, and they don`t come in until it is out of control," he said.
He
said not only do many older Hmong distrust Western medicine, preferring
the use of traditional healers, but they don`t even have a word in
their language that means "cancer."
Mouaryang will explain to a
patient that cancer is "an infection that is out of control." To
convince them to get treatment, he will arrange for a meeting between
the patient and a Hmong cancer survivor.
Dao Moua of the Hmong
Women`s Heritage Association in Sacramento runs cancer education
classes and often accompanies Hmong cancer patients to their doctors`
appointments.
But even after guiding patients through one
successful round of cancer therapy, she encounters reticence when it
comes to follow-up care.
"The families feel that if they don`t
have any evidence that cancer has recurred, they don`t want to continue
treatment," she said.
Both Moua and Mouarayang said the younger
generations of Hmong, with better English language skills and more
exposure to American culture, are more likely to embrace Western
medical practices.
But if becoming more "Westernized" helps
Asian Americans gain access to preventive care and cancer treatment, it
is also increasing disease risk factors.
As is the case in every group of Americans, obesity is on the rise among Asian Americans, particularly children.
"The
immediate concern is type 2 diabetes and longer range it would be heart
disease and cancer," said Susan Foerster, chief of cancer prevention
and nutrition for the California Department of Health Services.
Most
worrisome, she said, is that Asian Americans seem to have a lower
tolerance for obesity in that they develop type 2 diabetes at lower
weights than other groups.
Marjorie Kagawa-Singer, a public
health and Asian American studies professor at UCLA, researched the
trend among low-income Vietnamese, Chinese and Hmong families from
throughout the state.
"We found that parents want to teach their
children how to live healthy lives, but they weren`t clear on what that
means in America, so they listen to the media," she said. The result,
she said, can be diets that abandon traditional - and healthier -
dishes in favor of more convenient but less nutritious options.
Kagawa-Singer said oft-used nutrition messages need to be tailored to the various Asian subcultures to be useful.
New smoking data also revealed the effects of Americanization on Asian Americans.
The
good news is that while Asian men smoke at slightly higher rates than
California men generally, their ranks drop as they learn English. The
bad news is that for Asian American women, it`s just the opposite.
"The
assumption is that because traditionally Asian women are more
conservative, when they`re more acculturated they are more empowered
and try to be Westernized," said Hao Tang, a research scientist with
the state`s Tobacco Control Section. "Smoking is seen as a freedom."
That finding, he said, will help target anti-smoking programs to young Asian American women.
