In the summer of 2018, while traveling for work, Christina Kashiwada noticed a small, itchy lump on her left breast.
She didn’t think much of it at first. She did regular self-checks and kept up with her medical appointments. However, her relatives advised her to undergo a mammogram. She took the advice and was shocked to learn she had stage 3 breast cancer.
“I’m 36 years old, right?” says Kashiwada, a civil engineer from Sacramento, California. “No one thinks about cancer.”
In 2021, approximately 11,000 Asian American and Pacific Islander women were diagnosed with breast cancer, and approximately 1,500 died. The latest federal data shows that new breast cancer diagnoses are occurring at a much faster rate for Asian American and Pacific Islander women, a group that once had relatively low diagnosis rates, than for many other racial and ethnic groups. It shows that it is increasing. This tendency is especially noticeable among young women like Ms. Kashiwada.
According to age-adjusted data from the National Institutes of Health, approximately 55 breast cancers per 100,000 Asian American and Pacific Islander women under age 50 will be diagnosed in 2021, with a higher prevalence among Black and Hispanic women. The incidence rate was higher than that of white women, and the incidence was comparable to that of white women. health. (Hispanic people can be any race or combination of races, but are grouped separately in this data.)
New breast cancer incidence among Asian American and Pacific Islander women under age 50 increased by approximately 52% from 2000 to 2021. During that time, the incidence among AAPI women ages 50 to 64 increased by 33%, and the incidence among AAPI women ages 65 and older increased by 43%. period. By comparison, the proportion of women of all ages, races, and ethnicities increased by 3%.
Researchers have noticed this trend and are rushing to understand why it is occurring within this ethnically diverse group. They suspect the answer is complex, from cultural changes to high-pressure lifestyles, but remains a mystery, and cultural differences make it difficult for patients and their families to discuss. I admit it’s difficult.
Helen Chu, director of the Clinical Breast Cancer Program at the University of California, Davis Health, said the Asian American diaspora is so extensive and diverse that a simple explanation for the increase in breast cancer is not clear.
“This is a real trend,” Chu said, adding, “It’s difficult to say exactly why. Is it because of an influx of people who don’t have access to care? Or is it due to a variety of cultural factors?” Is that so?” he added. Is it a place they might not want to go into if they see something on the chest? ”
There is an urgent need to solve this mystery, as lives are at stake. While women of most ethnic and racial groups have experienced sharp declines in breast cancer mortality rates, Asian American and Pacific Islander women of all ages will experience a sharp decline in breast cancer mortality rates, with approximately 12 in 100,000 breast cancer deaths occurring in 2023. The number of deaths from breast cancer in Japan is almost the same as in 2000. Preliminary age-adjusted data from Centers for Disease Control and Prevention. Breast cancer mortality rates for all women decreased by 30% during this period.
The CDC does not publish breast cancer mortality rates for various groups of Asian American women, such as Chinese and Korean women. But we’re starting to differentiate between Asian American women and Pacific Islander women.
From 2018 to 2023, nearly 9,000 Asian American women died from breast cancer, compared to about 500 Native Hawaiian and Pacific Islander women. However, the breast cancer death rate during that period was 116% higher for Native Hawaiian and Pacific Islander women than for Asian American women.
The incidence of pancreatic cancer, thyroid cancer, colon cancer, endometrial cancer, and non-Hodgkin lymphoma also recently increased among Asian Americans and Pacific Islanders under age 50, according to NIH data. There is a significant increase in women. However, breast cancer is much more common among young AAPI women than other types of cancer. Young women are of particular concern because they are more likely to face a more aggressive disease and have higher mortality rates.
“We’re seeing an increase of almost 4% per year,” said Scarlett Gomez, a professor and epidemiologist at the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco. “This is even higher than the 4% annual increase for Asian/Pacific Islander women under 50.”
Gomez is the principal investigator on a large study investigating the causes of cancer in Asian Americans. She said there isn’t enough research yet to know what’s causing the recent surge in breast cancer cases. The answer may involve multiple risk factors over time.
“One of the hypotheses we’re studying there is the role of stress,” she said. “We’re asking all kinds of questions about different sources of stress and different ways of coping throughout the lifespan.”
It seems that the number of examinations will not only increase. “When we looked at trends by stage at diagnosis, we saw similar rates of increase across all stages of the disease,” Gomez said.
Veronica Setiawan, a professor and epidemiologist at the Keck School of Medicine at the University of Southern California, said the trend may be related to Asian immigrants adopting lifestyles that put them at higher risk. . Setiawan is a breast cancer survivor who was diagnosed with breast cancer several years ago at the age of 49.
“Both Asian women and American women have become more Westernized and now have younger puberty. Earlier age[at first menstrual cycle]is associated with increased risk.” said Professor Setiawan, who works with Gomez on cancer research. “They’re probably going to give birth later, they’re going to give birth later, they might not breastfeed, all of which are associated with breast cancer risk.”
Moon Chen, a professor at the University of California, Davis and an expert on cancer health disparities, added that only a small portion of NIH funding goes to cancer research in Asian Americans. .
Whatever the cause, this trend has caused many patients years of suffering.
Ms. Kashiwada was diagnosed with breast cancer and underwent a mastectomy. During surgery, doctors at UC Davis Health discovered that the cancer had spread to the lymph nodes in his armpit. She underwent eight rounds of chemotherapy and 20 rounds of radiation therapy.
During his treatment, Kashiwada kept his ordeal a secret from his grandmother, who raised him. Her grandmother had no idea about this diagnosis. “I didn’t want to worry her or put her under stress,” Kashiwada said. “She probably would never sleep knowing this was happening. It was very important to me to protect her.”
Mr. Kashiwada moved in with his parents. Her mother took time off from work to help care for her.
Kashiwada’s two young children, ages 3 and 6 at the time, stayed with their father so Kashiwada could focus on his recovery.
“The kids used to come after school,” she said. “Almost every day while their father was at work, he would pick up the children and come see me.”
Kashiwada spent several months regaining his strength after radiation therapy. She returned to work, but her doctor told her not to lift heavy objects.
Kashiwada underwent her final reconstructive surgery a few weeks before the coronavirus lockdown began in 2020, but her treatment was not yet complete.
Doctors told her that estrogen caused cancer and gave her drugs to induce early menopause. The treatment wasn’t as effective as they had hoped. Her doctors performed surgery to remove her ovaries in 2021.
She was recently diagnosed with osteopenia and plans to start injections to prevent bone loss.
Kashiwada said she has overcome the many negative emotions she felt about her illness and wants other young women, including Asian American women like her, to be aware of their increased risk. Ta.
“No matter how healthy you think you are, no matter how much exercise you do, no matter what you do, eating well, that’s all I did. That’s what makes you invincible, “I would say it doesn’t boost immunity or anything,” she said. . “That doesn’t mean you should be afraid of everything, but be in tune with your body and what it’s telling you.”
Philip Reese is a data reporting specialist and associate professor of journalism at California State University, Sacramento.
This article was produced by KFF Health News. KFF Health News is a national newsroom producing in-depth journalism on health issues, one of KFF’s core operating programs, and an independent source of health policy research, polling and journalism. KFF Health News is the publisher of California Healthline, an editorially independent service of the California Health Care Foundation.
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