J. Wu1,2, Y. Hung2, S. M. Stapleton2, Y. Hsu2, S. T. Oseni2, C. Huang1, D. C. Chang2 1National Taiwan University Hospital,Surgery,Taipei, Taiwan 2Massachusetts General Hospital,Surgery,Boston, MA, USA
Introduction:
More than half of the Asian Americans with breast cancer were born in Asia, however it is unknown whether their disease patterns are different from Asians born in the US. We hypothesize that nativity status may have an impact on the onset and the presentation of breast cancer in the Asian population.
Methods:
A retrospective analysis was performed for Asian females³ 20 years old in the US Surveillance, Epidemiology, and End Results (SEER) Program database, and as a convenience sample from Asia, in the Taiwan Cancer Registry (TCR) for the years 2004-2010. The primary end point was proportion of patients who had early-onset breast cancer, defined as breast cancer age at onset before 50. Secondary outcome was the proportion of advanced breast cancers, defined by American Joint Committee on Cancer staging III to IV. Three groups of patients were compared: Native Asian in Taiwan (TW), Asia-born Asian American (AAA), and US-born Asian American (USAA).
Results:
We identified 13,404 patients (2,743 USAA & 10,661 AAA) in SEER and 49,322 TW in TCR. TW presented at an earlier age than AAA (median age 51vs 56) and USAA (median 61). TW had the highest proportion of early-onset breast cancer (44.3% vs 31.7% AAA and 23.7% USAA, p < 0.001). In addition, both TW and AAA had significantly higher rates of advanced cancer at presentation than USAA (22.8% and 17.2% vs 13.8%, respectively, p < 0.001).
Conclusions:
Recent immigrants to the US may be at increased risk of earlier and more aggressive breast cancers. Future studies should determine whether these differences are due to biomedical factors, access to healthcare, or poor healthcare quality affecting immigrant communities. The impact of immigration on health and disease remains an under-appreciated but important way through which we can further understand the interaction between social and biomedical factors on disease onset and progression.
