Raz Dan J, Gomez Scarlett L, Chang Ellen T, Kim Jae Y, Keegan Theresa H M, Pham Jane, Kukreja Jasleen, Hiatt Robert A, Jablons David M
Thoracic Oncology Program, Department of Surgery, University of California, San Francisco, California 94131, USA.
J Thorac Oncol. 2008 Dec;3(12):1391-7. doi: 10.1097/JTO.0b013e31818ddff7.
Differences in the epidemiology of lung cancer between Asians and non-Hispanic whites have brought to light the relative influences of genetic and environmental factors on lung cancer risk. We set out to describe the epidemiology of non-small cell lung cancer (NSCLC) among Asians living in California, and to explore the effects of acculturation on lung cancer risk by comparing lung cancer rates between U.S.-born and foreign-born Asians.
Age-adjusted incidence rates of NSCLC were calculated for Chinese, Filipino, Japanese, Korean, Vietnamese, and South Asians in California between 1988 and 2003 using data from the California Cancer Registry. Incidence rates were calculated and stratified by sex and nativity. We analyzed population-based tobacco smoking prevalence data to determine whether differences in rates were associated with prevalence of tobacco smoking.
Asians have overall lower incidence rates of NSCLC compared with whites (29.8 and 57.7 per 100,000, respectively). South Asians have markedly low rates of NSCLC (12.0 per 100,000). Foreign-born Asian men and women have an approximately 35% higher rate of NSCLC than U.S.-born Asian men and women. The incidence pattern by nativity is consistent with the population prevalence of smoking among Asian men; however, among women, the prevalence of smoking is higher among U.S.-born, which is counter to their incidence patterns.
Foreign-born Asians have a higher rate of NSCLC than U.S.-born Asians, which may be due to environmental tobacco smoke or nontobacco exposures among women. South Asians have a remarkably low rate of NSCLC that approaches white levels among the U.S.-born. More studies with individual-level survey data are needed to identify the specific environmental factors associated with differential lung cancer risk occurring with acculturation among Asians.
亚洲人与非西班牙裔白人在肺癌流行病学方面的差异揭示了遗传和环境因素对肺癌风险的相对影响。我们旨在描述居住在加利福尼亚州的亚洲人中非小细胞肺癌（NSCLC）的流行病学情况，并通过比较在美国出生和国外出生的亚洲人的肺癌发病率来探讨文化适应对肺癌风险的影响。
利用加利福尼亚癌症登记处的数据，计算了1988年至2003年间加利福尼亚州华裔、菲律宾裔、日裔、韩裔、越南裔和南亚裔人群中NSCLC的年龄调整发病率。发病率按性别和出生地进行计算和分层。我们分析了基于人群的吸烟流行率数据，以确定发病率差异是否与吸烟流行率相关。
与白人相比，亚洲人NSCLC的总体发病率较低（分别为每10万人29.8例和57.7例）。南亚人的NSCLC发病率显著较低（每10万人12.0例）。国外出生的亚洲男性和女性患NSCLC的几率比在美国出生的亚洲男性和女性高约35%。按出生地划分的发病模式与亚洲男性人群中的吸烟流行情况一致；然而，在女性中，美国出生者的吸烟流行率较高，这与她们的发病模式相反。
国外出生的亚洲人患NSCLC的几率高于在美国出生的亚洲人，这可能是由于女性接触环境烟草烟雾或非烟草暴露所致。南亚人的NSCLC发病率极低，接近美国出生人群中的白人水平。需要更多基于个体层面调查数据的研究，以确定与亚洲人文化适应过程中肺癌风险差异相关的具体环境因素。
