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Colorectal cancer incidence in Asian populations in California: effect of nativity and neighborhood-level factors

TitleColorectal cancer incidence in Asian populations in California: effect of nativity and neighborhood-level factors
Publication TypeJournal Article
Year of Publication2014
AuthorsLadabaum, U, Clarke, CA, Press, DJ, Mannalithara, A, Myer, PA, Cheng, I, Gomez, SL
JournalAm J GastroenterolAm J Gastroenterol
Date PublishedApr
ISBN Number1572-0241 (Electronic)<br/>0002-9270 (Linking)
Accession Number24492754
KeywordsAdult, Aged, Aged, 80 and Over, Asian Americans, California/epidemiology, China/ethnology, Cohort Studies, Colorectal Neoplasms/economics/ ethnology/etiology, Emigrants and Immigrants, European Continental Ancestry Group, Female, Humans, Incidence, Japan/ethnology, Male, Middle Aged, Models, Statistical, Philippines/ethnology, Regression Analysis, Residence Characteristics, Risk Factors, SEER Program, Social Class
AbstractOBJECTIVES: Heritable and environmental factors may contribute to differences in colorectal cancer (CRC) incidence across populations. We capitalized on the resources of the California Cancer Registry (CCR) and California's diverse Asian population to perform a cohort study exploring the relationships between CRC incidence, nativity, and neighborhood-level factors across Asian subgroups. METHODS: We identified CRC cases in the CCR from 1990 to 2004 and calculated age-adjusted CRC incidence rates for non-Hispanic Whites and US-born vs. foreign-born Asian ethnic subgroups, stratified by neighborhood socioeconomic status (SES) and "ethnic enclave." Trends were studied with joinpoint analysis. RESULTS: CRC incidence was lowest among foreign-born South Asians (22.0/100,000; 95% confidence interval (CI): 19.7-24.5/100,000) and highest among foreign-born Japanese (74.6/100,000; 95% CI: 70.1-79.2/100,000). Women in all Asian subgroups except Japanese, and men in all Asian subgroups except Japanese and US-born Chinese, had lower CRC incidence than non-Hispanic Whites. Among Chinese men and Filipino women and men, CRC incidence was lower among foreign-born than US-born persons; the opposite was observed for Japanese women and men. Among non-Hispanic Whites, but not most Asian subgroups, CRC incidence decreased over time. CRC incidence was inversely associated with neighborhood SES among non-Hispanic Whites, and level of ethnic enclave among Asians. CONCLUSIONS: CRC incidence rates differ substantially across Asian subgroups in California. The significant associations between CRC incidence and nativity and residence in an ethnic enclave suggest a substantial effect of acquired environmental factors. The absence of declines in CRC incidence rates among most Asians during our study period may point to disparities in screening compared with Whites.
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