NCI Reports on Cancer Incidence and Mortality in Minorities

The Surveillance, Epidemiology and End Results (SEER) Programof the National Cancer Institute (NCI) has published a study reportingon patterns of cancer in a variety of racial and ethnic groupsin the United States.

The SEER monograph, Racial/Ethnic Patterns of Cancer in theUnited States, 1988-1992, includes average annual age-adjustedcancer incidence rates for the Alaska Native, American Indian(New Mexico), black, Chinese, Filipino, Hawaiian, Japanese, Korean,Vietnamese, and white populations. The data are also presentedfor Hispanic (total), white Hispanic, and white non-Hispanic populations.Cancer mortality, compiled by the NCI using data from the NationalCenter for Health Statistics, is reported for each of these groupsexcept Korean and Vietnamese, for whom data are unavailable.

Also included are estimates of the number of newly diagnosed cancersand cancer deaths in the United States, by cancer site, for eachracial/ethnic group in 1990. Selected data from the report arereproduced below.

Reaching Those Most In Need

"We are pleased to have this study completed, because ithelps us tailor our education, outreach, and intervention effortsto reach populations most in need," said Brenda K. Edwards,phd, director of NCI's Cancer Control Research Program. "Wealso anticipate extensive use of these data by the health careand research community."

Benjamin F. Hankey, scd, chief of NCI's Cancer Statistics Branch,added, "The data provide a basis for monitoring cancer ratesin diverse populations, with unique cultures and lifestyles aswell as possibly unique genetic factors that may influence cancerrisk."

The SEER Program is a continuing project of NCI, responsible formonitoring the impact of cancer in the general population. Itconsists of a network of cancer registries that cover the statesof Connecticut, Hawaii, Iowa, New Mexico, and Utah; and the metropolitanareas of Atlanta (including 10 rural counties), Detroit, Los Angeles,San Francisco/Oakland, San Jose/Monterey (California), and Seattle/PugetSound. In addition, data were provided by the Alaska Area NativeHealth Service for use in the monograph.

The SEER Program covers about 14% of the US population overall,but by design includes substantially larger percentages of minoritypopulations: 78% of

Hawaiians, 60% of Japanese, 49% of Filipinos, 43% of Chinese,34% of Koreans, 31% of Vietnamese, 27% of American Indians, and25% of Hispanics. This is necessary to enable the calculationof cancer rates for these smaller populations.

Broad Similarities on Some Measures of Cancer

The racial/ethnic groups were found to be broadly similar on somemeasures of cancer. Men have higher overall cancer rates thanwomen in all groups. The ratio of male to female incidence ratesranges from 1.1:1 in Alaska Natives to 1.7:1 in blacks. However,in all groups, women 30 to 54 years old have higher rates thanmen of the same age range, due to the high incidence of femalebreast and gynecologic cancers.

Black men have the highest overall cancer incidence and mortality,largely due to excesses of prostate and lung cancers. Among women,cancer is most common in non-Hispanic whites, while the cancerdeath rate is highest in Alaska Natives.

One chapter of the report cites the five most frequently diagnosedcancers and the five most common causes of cancer death for eachracial/ethnic group. Breast cancer incidence ranks first in allgroups of women except Vietnamese, who have a higher rate of cervicalcancer. However, breast cancer incidence rates vary fourfold,from 28.5 per 100,000 Korean women to 115.7 per 100,000 non-Hispanicwhite women.

In terms of mortality, lung cancer ranks first in most groupsof women, and is in either first or second place in all groupsexcept American Indians. Breast cancer mortality ranks in thetop two sites for all groups of women except Alaska Natives, inwhom it ranks third.

Among men, either prostate or lung cancer ranks first in eachracial/ethnic group for both incidence and mortality. Prostatecancer incidence varies more than sevenfold, from 24.2 per 100,000Koreans to 180.6 per 100,000 blacks. Colorectal cancer incidencerates also vary substantially: The Alaska Native rates are morethan four times as high as the American Indian rates for bothmen and women.

A few generally rare cancers appear in the top five sites forspecific groups. Cancer of the gallbladder ranks fourth in AmericanIndian women in New Mexico, for instance, while thyroid canceris fourth in Filipino women. Nasopharyngeal cancer, which is commonin China and Southeast Asia, occurs much more frequently in Chineseand Vietnamese American men than in blacks, whites, and othergroups, although it does not make the top five sites in any group.