Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, Hawaii.
Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
Cancer Epidemiol Biomarkers Prev. 2024 Oct 2;33(10):1311-1317. doi: 10.1158/1055-9965.EPI-24-0647.
Filipino Americans constitute 12% and 4% of the respective populations of Hawaii and California, with a large proportion of immigrants experiencing increasing cancer rates. This study investigated the incidence of colorectal, breast, and prostate cancers by generational status in the Multiethnic Cohort.
We analyzed 10,495 Filipino Multiethnic Cohort first-, second-, and third-generation participants, in which 26.8% were of mixed race and ethnicity. Linkage to statewide cancer registries identified 375 breast, 249 colorectal, and 436 prostate cancer incident cases. Cox models were used to calculate HRs and 95% confidence intervals (CI) for the association between generational status and cancer incidence. Models were adjusted for age at cohort entry and cancer-specific covariates that were chosen based on stepwise regression.
Compared with the first generation, colorectal cancer showed a significantly higher incidence in the second and third generations with respective HRs of 1.43 (95% CI, 1.04, 1.98) and 1.76 (95% CI, 1.29, 2.38). This association was attenuated after adjustment for relevant covariates. Breast cancer incidence was elevated in the third versus first generation (HR = 1.29; 95% CI, 1.01, 1.63) even in the fully adjusted model, whereas little difference was observed for prostate cancer.
In this prospective study, we found differences in incidence by generational status, specifically colorectal cancer among men and female breast cancer.
Understanding behavioral changes due to acculturation is warranted to mitigate cancer risks in migrant populations.
菲律宾裔美国人分别占夏威夷和加利福尼亚州人口的 12%和 4%,其中很大一部分移民的癌症发病率不断上升。本研究通过世代状况调查了夏威夷和加利福尼亚州菲律宾裔美国人中结直肠癌、乳腺癌和前列腺癌的发病率。
我们分析了 10495 名菲律宾裔多种族队列的第一代、第二代和第三代参与者,其中 26.8%为混血儿。与全州癌症登记处的联系确定了 375 例乳腺癌、249 例结直肠癌和 436 例前列腺癌的发病病例。Cox 模型用于计算世代状况与癌症发病率之间的关联的 HR 和 95%置信区间(CI)。模型根据逐步回归选择了基于年龄的队列进入和癌症特异性协变量进行调整。
与第一代相比,第二代和第三代结直肠癌的发病率明显更高,相应的 HR 分别为 1.43(95%CI,1.04,1.98)和 1.76(95%CI,1.29,2.38)。在调整了相关协变量后,这种关联减弱了。即使在完全调整的模型中,乳腺癌的发病率在第三代也高于第一代(HR=1.29;95%CI,1.01,1.63),而前列腺癌的差异则较小。
在这项前瞻性研究中,我们发现世代状况的发病率存在差异,特别是男性结直肠癌和女性乳腺癌。
有必要了解由于文化适应而导致的行为变化,以减轻移民人群的癌症风险。