Incidence Trends of Lung Cancer by Immigration Status among Chinese Americans

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Abstract
Background: Lung cancer is the leading cause of cancer-related death among Chinese Americans. A detailed examination of incidence trends by immigration status and histology may inform the etiology of lung cancer in this growing population. Methods: California Cancer Registry data were enhanced with data on patient nativity. Lung cancer incidence rates for Chinese males and females were computed for the years 1990–2010, and rates by immigration status and histology were computed for 1990–2004. Trends were assessed with annual percentage change (APC) statistics (two-sided P values) based on linear regression. Results: A total of 8,167 lung cancers were diagnosed among California Chinese from 1990 to 2010. Overall incidence increased nonstatistically among U.S.-born males (APC, 2.1; 95% CI, −4.9 to 9.7), but decreased significantly among foreign-born (APC, −1.7; 95% CI, −2.9 to −0.6). Statistically significant decreasing trends were observed for non–small cell lung cancer (NSCLC), specifically the squamous cell and large cell carcinoma subtypes among foreign-born males. Among females, incidence decreased nonsignificantly among U.S.-born (APC, −2.8; 95% CI, −9.1 to 4.0) but was stable among foreign-born (APC, −0.4; 95% CI, −1.7 to 1.0). A statistically significant decreasing trend was observed for squamous cell among foreign-born females. Conclusions: These data provide critical evidence base to inform screening, research, and public health priorities in this growing population. Impact: Given the low smoking prevalence among Chinese Americans, especially females, and few known lung cancer risk factors in U.S. never-smoker populations, additional research of etiologic genetic or biologic factors may elucidate knowledge regarding lung cancer diagnosed in never smokers. Cancer Epidemiol Biomarkers Prev; 24(8); 1157–64. ©2015 AACR.

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