New research co-authored by a UCLA Fielding School of Public Health scientist has found Native Hawaiian women have a 27% higher breast cancer incidence than white women and have the highest rates in the U.S. when the records for Asian American and NHPI women are not combined.
“Despite federal guidelines established nearly 30 years ago to disaggregate NHPI data from Asian American data, national cancer statistics continue to combine and mask the true NHPI cancer burden until recently, reinforcing the perception that Asian American and NHPI populations uniformly experience favorable outcomes,” said Dr. Kekoa Taparra, assistant professor in the Department of Health Policy and Management at the UCLA Fielding School of Public Health and in the Department of Radiation Oncology at UCLA’s David Geffen School of Medicine. “As a Native Hawaiian who has seen many Pacific Islanders affected by cancer, this new data is powerful and more accurately reflects the experiences of so many within our community.”
The peer-reviewed study – “Cancer statistics for Asian American, Native Hawaiian, and Pacific Islander people, 2026” – was published in the September edition of Cancer, an international journal of the American Cancer Society (ACS). Taparra’s co-authors include researchers and medical experts from across the oncology, public health, healthcare, and medical disciplines, ACS officials said.
"Behind the aggregated Asian American and NHPI data are separate populations experiencing some of the highest cancer incidence rates in the country,” said Dr. Nikita Wagle, lead author of the study. “Korean people have the highest stomach cancer incidence of any racial-ethnic group in the U.S. Similarly, Vietnamese people have the highest liver cancer incidence, and Samoan women have the highest uterine corpus cancer incidence."
For the study, researchers examined population-based cancer registry data from the (U.S.) National Cancer Institute’s Surveillance, Epidemiology, and End Results program, containing information on Asian American and NHPI ethnic groups from 2000 through 2022, to report on cancer incidence and survival.
Key findings (note all these references are to cancer diagnoses in the United States):
- Female breast cancer incidence in the U.S. is on the rise in almost all Asian American and NHPI ethnic groups, ranging from 1% per year in (U.S.) Native Hawaiian and Filipino women to 3%-5% per year in Guamanian/Chamorro, Chinese, Vietnamese, and Korean women.
- Native Hawaiian women in the U.S. had the highest breast cancer incidence rate among Asian American and NHPI ethnic groups, exceeding that in Asian American and NHPI women combined by 57% and in white women in the U.S. by 27%.
- Colorectal cancer incidence among Native Hawaiian people in the U.S. is 37% higher than among Asian American and NHPI people combined and 11% higher than among white Americans.
- Among Asian American and NHPI men in the U.S., prostate cancer incidence is six times higher in Native Hawaiian men, who have the highest rate, than in Laotian men, who have the lowest rate.
- In addition, in the U.S., Cambodian people had the lowest cancer incidence rate (218.3 per 100,000), and Native Hawaiian people had the highest rate (474.5 per 100,000), which was 1.5 times the rate when Asian American and NHPI people are combined (307.3 per 100,000).
- Overall, cancer incidence varied by more than twofold across the 11 Asian American and NHPI ethnic groups in the U.S.
“You can’t fix a problem you don’t know is there. Favorable rates in the Asian American and NHPI population as a whole mask the highest national burden for many cancers, including breast and endometrial cancers in women,” said Rebecca Siegel, senior author of the report. “Especially in these communities, successful interventions must be tailored, not a one-size-fits-all approach.”
Those realities are especially pertinent in southern California, which has some of the largest Asian American and Pacific Islander populations in the U.S. outside of the state of Hawaii.
“Los Angeles County is home to more Pacific Islanders than any other county in the continental U.S.,” said Taparra, who is also an investigator at the UCLA Health Jonsson Comprehensive Cancer Center. “California, likewise, has the largest Pacific Islander population of any state on the continental U.S. This makes both Los Angeles County and California well positioned to serve as critical places to not only understand the high burden of cancer among Pacific Islanders but also lead efforts on how to potentially reduce it, for this generation and those to come.”
Funding
This study was supported by the American Cancer Society, an Atlanta-based advocacy and research organization. The Society's mission is to is to improve the lives of people with cancer and their families through advocacy, research, and patient support.
