Program in Health Disparities Research, University of Minnesota Medical School, University of Minnesota, Minneapolis, Minnesota, USA.
Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
Int J Cancer. 2020 Dec 15;147(12):3339-3348. doi: 10.1002/ijc.33153. Epub 2020 Jul 13.
Despite the vast genetic and environmental diversity in Asia, individuals of Asian and Pacific Islander (API) descent are often combined into a single group for epidemiologic analyses within the U.S. We used the Surveillance, Epidemiology and End Results (SEER) Detailed Asian/Pacific Islander Database to calculate incidence rates for discrete groups among children aged 0 to 19 years. Due to sample size constraints we pooled incidence among regional groups based on countries of origin: East Asians (Chinese, Japanese, Korean), Southeast (SE) Asians (Vietnamese, Laotian, Cambodian), Asian Indian/Pakistani, Oceanians (Guamanian, Samoan, Tongan) and Filipinos. Incidence rate ratios (IRR) and 95% confidence intervals (CI) were calculated comparing each API regional group to Non-Hispanic Whites (NHW) and East Asians. Finally, we calculated the correlation between incidence of cancer in specific API ethnicities in SEER and in originating countries in the Cancer Incidence in Five Continents. Incidence rates among API regional groups varied. Acute lymphoblastic leukemia (ALL) was lower in children of SE Asian descent (IRR 0.65, 95% CI 0.44, 0.96) compared to NHW. Acute myeloid leukemia (AML) was more common among children from Oceania compared to NHW (IRR 3.88, 95% CI 1.83, 8.22). East Asians had higher incidence rates than SE Asians but lower rates compared to children from Oceania. Correlation of some incidence rates between US-based API ethnicities and originating countries were similar. The variation observed in childhood cancer incidence patterns among API groups may indicate differences in underlying genetics and/or patterns of exposure.
尽管亚洲存在着广泛的遗传和环境多样性,但在美国的流行病学分析中,亚洲和太平洋岛民(API)后裔通常被归为一个单一的群体。我们使用监测、流行病学和最终结果(SEER)详细的亚太数据库来计算 0 至 19 岁儿童中不同群体的发病率。由于样本量的限制,我们根据原籍国将区域性群体的发病率进行了汇总:东亚人(中国人、日本人、韩国人)、东南亚人(越南人、老挝人、柬埔寨人)、南亚印度/巴基斯坦人、大洋洲人(关岛人、萨摩亚人、汤加人)和菲律宾人。通过比较每个 API 区域组与非西班牙裔白人(NHW)和东亚人,计算发病率比率(IRR)和 95%置信区间(CI)。最后,我们计算了特定 API 族裔在 SEER 中的癌症发病率与癌症在五个大陆的发病率之间的相关性。API 区域性群体的发病率各不相同。与 NHW 相比,东南亚裔儿童的急性淋巴细胞白血病(ALL)发病率较低(IRR0.65,95%CI0.44,0.96)。与 NHW 相比,来自大洋洲的儿童急性髓细胞白血病(AML)更为常见(IRR3.88,95%CI1.83,8.22)。东亚人的发病率高于东南亚人,但低于大洋洲人。美国基于 API 族裔的一些发病率与原籍国之间的相关性相似。在 API 群体中观察到的儿童癌症发病率模式的差异可能表明潜在遗传学和/或暴露模式的差异。