Lee Richard J, Madan Ravi A, Kim Jayoung, Posadas Edwin M, Yu Evan Y
Harvard Medical School and Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA.
Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Oncologist. 2021 Jun;26(6):453-460. doi: 10.1002/onco.13748. Epub 2021 Mar 20.
Asian Americans are the only racial/ethnic group in the U.S. for whom cancer is the leading cause of death in men and women, unlike heart disease for all other groups. Asian Americans face a confluence of cancer risks, with high rates of cancers endemic to their countries of origin due to infectious and cultural reasons, as well as increasing rates of "Western" cancers that are due in part to assimilation to the American diet and lifestyle. Despite the clear mortality risk, Asian Americans are screened for cancers at lower rates than the majority of Americans. Solutions to eliminate the disparity in cancer care are complicated by language and cultural concerns of this very heterogeneous group. This review addresses the disparities in cancer screening, the historical causes, the potential contribution of racism, the importance of cultural perceptions of health care, and potential strategies to address a very complicated problem. Noting that the health care disparities faced by Asian Americans may be less conspicuous than the structural racism that has inflicted significant damage to the health of Black Americans over more than four centuries, this review is meant to raise awareness and to compel the medical establishment to recognize the urgent need to eliminate health disparities for all. IMPLICATIONS FOR PRACTICE: Cancer is the leading cause of death in Asian Americans, who face cancers endemic to their native countries, perhaps because of infectious and cultural factors, as well as those faced by all Americans, perhaps because of "Westernization" in terms of diet and lifestyle. Despite the mortality rates, Asian Americans have less cancer screening than other Americans. This review highlights the need to educate Asian Americans to improve cancer literacy and health care providers to understand the important cancer risks of the fastest-growing racial/ethnic group in the U.S. Eliminating disparities is critical to achieving an equitable society for all Americans.
在美国，亚裔美国人是唯一一个癌症成为男性和女性首要死因的种族/族裔群体，这与其他所有群体以心脏病为首要死因不同。亚裔美国人面临多种癌症风险，由于感染和文化因素，其原籍国特有的癌症发病率较高，同时“西方”癌症发病率也在上升，这部分归因于对美国饮食和生活方式的同化。尽管存在明显的死亡风险，但亚裔美国人接受癌症筛查的比例低于大多数美国人。消除癌症护理差距的解决方案因这个非常多样化群体的语言和文化问题而变得复杂。本综述探讨了癌症筛查方面的差距、历史成因、种族主义的潜在影响、医疗保健文化观念的重要性以及解决这一非常复杂问题的潜在策略。需要指出的是，亚裔美国人面临的医疗保健差距可能不如对美国黑人健康造成重大损害超过四个多世纪的结构性种族主义那么明显，本综述旨在提高认识，并促使医疗机构认识到消除所有人健康差距的迫切需要。对实践的启示：癌症是亚裔美国人的首要死因，他们面临着本国特有的癌症，这可能是由于感染和文化因素，以及所有美国人都面临的癌症，这可能是由于饮食和生活方式方面的“西方化”。尽管有死亡率，但亚裔美国人接受癌症筛查的比例低于其他美国人。本综述强调有必要对亚裔美国人进行教育，以提高癌症知识水平，并让医疗保健提供者了解美国增长最快的种族/族裔群体面临的重要癌症风险。消除差距对于为所有美国人实现公平社会至关重要。
