Younger Asian American women tie for highest breast cancer rate

A sharp increase in incidence and mortality rates among 18-49-year-old women

Chien-Chi Huang was 40 when she requested her first mammogram at the hospital, shortly after her aunt died from breast cancer. The radiologist didn’t detect a tumor because she had dense breast tissue that can hide cancer on a mammogram.

Soon after the mammogram, Huang said she felt a lump under her armpit and began experiencing flu-like symptoms. Four months later, she was diagnosed with triple-negative breast cancer, one of the most aggressive forms of the disease.

Acculturation and cultural factors may contribute to rising rates

“As Asian Americans, we don’t have a prevention mindset and tend to only go to the hospital when we’re sick,” said Huang, now 59 and an advocate for early screening among Asian American women.

Since 2000, breast cancer incidence among Asian American and Pacific Islander women under 50 years old has increased by 50%, more than 2% every year since 2012, according to a new report from the American Cancer Society.

AAPI women in this age cohort had the second-lowest rate of breast cancer among all racial groups in 2000. They now have the highest rate, alongside white women, about 86 per 100,000, NBC News reports.

Dense breasts, cultural barriers and socioeconomic disparities may contribute to rising rates

Asian women like Huang have a higher prevalence of dense breasts, meaning there are more glands and tissue than fat, likely due to genetic factors and lower body mass indexes, experts say. And women with dense breasts are four times as likely to develop breast cancer as those with fatty breasts, an issue experts say needs more awareness.

One possible reason for the spike in breast cancer incidence among AAPI women is increased westernization, or the adoption of lifestyle choices not endemic to Asia, said Scarlett Lin Gomez, an epidemiologist at the University of California, San Francisco, who’s leading the first long-term study of cancer among Asian Americans.

“Established risk factors for breast cancer have typically been more common in westernized and industrialized countries,” Gomez said, noting that the increase in breast cancer among women in Asia has been linked to economic development and practices such as delayed childbearing, eating a Western diet high in refined grains and trans fats, growing alcohol consumption and the use of hormone therapy.

Risks and warning signs

Late pregnancies may increase the risk of breast cancer because breast cells have more time to accumulate genetic damage as a woman ages, and hormonal changes during pregnancy can stimulate the growth of damaged cells.

Asian women who immigrate to the U.S. are more than twice as likely to develop breast cancer than U.S.-born Asian women, a trend that Gomez said could be associated with the higher socioeconomic status and education level of more recent immigrants.

Women from higher socioeconomic classes, Gomez said, tend to have “more risk factors for breast cancer, especially as they are coming from Asia, where we have been seeing very rapidly increasing rates of breast cancer.”

Subgroup disparities and socioeconomic status

Since Asian Americans are such a heterogeneous group, Chew said, incidence and mortality rates vary widely among different ethnic groups. Korean, Chinese, Filipina, and South Asian American women face the highest risk of breast cancer. Most Asian American women, including Chinese and Japanese Americans, are less likely to die from breast cancer than white women, but the mortality rates for Filipina and Pacific Islander women are 30% higher.

Socioeconomic status and education level, which vary widely between Asian Indians and Pacific Islanders or Southeast Asians, could explain these disparities in breast cancer incidence and mortality, Chew said.

Further research and awareness

Breast cancer is the only cancer with such vast disparities among AAPIs, Chew said, noting that researchers would have to conduct long-term studies on each subgroup to find answers. “You wonder if it has to do with education and class. Is it biology? Is it cultural? It’s hard to know.”

The mortality rate for Asian American women under 50 years old has not dropped in the past two decades, even though the death rate among all women has fallen by 30%. Studies have shown that Asian American women may be prone to a more aggressive type of breast cancer, caused by the HER2/neu protein, than women from other racial groups.

AAPI women collectively have among the lowest screening rates, which experts say may have contributed to a stabilizing, rather than falling, mortality rate. At the same time, the stigma around cancer is still widespread within the diaspora, as well as the culturally embedded belief that consulting a doctor is only necessary when the pain is unbearable.

Conclusion

Disaggregating data is key to understanding what’s driving the rapid rise in breast cancer among Asian women. It’s essential to recognize the complex interplay of cultural, socioeconomic, and environmental factors contributing to this trend and to develop targeted interventions to address it. As the numbers continue to rise, it’s crucial to amplify the voices of AAPI women and to promote awareness, education, and timely screenings to save lives.

FAQs

Q: Why are younger Asian American women at higher risk for breast cancer?

A: According to experts, it may be due to acculturation, cultural factors, and socioeconomic disparities, as well as genetic predispositions and environmental factors.

Q: What are the most critical risk factors for breast cancer among AAPI women?

A: Density, westernization, and socioeconomic status, as well as cultural barriers to healthcare access and stigma surrounding cancer diagnosis.

Q: How can AAPI women reduce their breast cancer risk?

A: By staying informed, staying proactive, and speaking to their healthcare providers about their risks and concerns, as well as by embracing a healthy lifestyle, including regular exercise and a balanced diet.

Q: What can be done to address the disparities in breast cancer among AAPI women?

A: By acknowledging and addressing the cultural and socioeconomic barriers, by promoting education and awareness, and by providing targeted support to vulnerable populations.