Thakkar Zeel, Khan Mohammed A, Wu Yan, Qi Xinran, Hung George A, Kikuta Nicholas, Jamal Armaan, Bacong Adrian M, Kim Karina M, Kim Gloria S, Palaniappan Latha P, Srinivasan Malathi, Huang Robert J
Stanford Center for Asian Health Research and Education (CARE), Stanford University School of Medicine, Stanford, California.
College of Arts and Sciences, New York University, New York, New York.
Cancer Epidemiol Biomarkers Prev. 2025 Jul 1;34(7):1134-1140. doi: 10.1158/1055-9965.EPI-24-1688.
Colorectal cancer is the second leading cause of cancer death in Asian Americans. Asian Americans are a diverse, heterogeneous population composed of groups with differing cancer risk factors. Few prior studies have analyzed colorectal cancer mortality by disaggregated Asian racial subgroup.
Using 2005 to 2020 US national mortality records linked to American Community Survey one-year population estimates, we report age-standardized mortality rates per 100,000 person-years, standardized mortality ratios (SMR), and average annual percent change trends for the six largest Asian subgroups in a serial, cross-sectional study design. We compared these rates with non-Hispanic Whites. We stratified rates by sex, nativity, and colorectal cancer location (colon vs. rectum).
Asian subgroups demonstrated substantial heterogeneity in colorectal cancer mortality. Relative to the non-Hispanic White group, Asian Indian Americans had the lowest rate [female SMR = 0.3; 95% confidence interval (CI), 0.3-0.3 and male SMR = 0.3; 95% CI, 0.3-0.3] and Japanese Americans the highest rate (female SMR = 0.9; 95% CI, 0.8-0.9 and male SMR = 0.9; 95% CI, 0.9-1.0). Chinese, Filipino, Korean, and Vietnamese Americans demonstrated mortality between Asian Indian and Japanese. Over the study period, most Asian subgroups had stable or decreasing mortality. However, both Korean and Vietnamese colorectal cancer mortality increased over the period. By the end of the study period, Korean Americans had the highest colorectal cancer mortality of any Asian subgroup.
Asian subgroups demonstrate heterogeneity in patterns of colorectal cancer mortality, emphasizing the necessity of disaggregation in cancer research.
Our study provides disaggregated Asian subgroup colorectal cancer mortality data, which may allow for targeted risk attenuation efforts.
结直肠癌是亚裔美国人癌症死亡的第二大主要原因。亚裔美国人是一个多样化、异质性的群体，由具有不同癌症风险因素的群体组成。此前很少有研究按细分的亚洲种族亚组分析结直肠癌死亡率。
在一项系列横断面研究设计中，我们利用2005年至2020年与美国社区调查一年人口估计数相关联的美国国家死亡率记录，报告每10万人年的年龄标准化死亡率、标准化死亡比（SMR）以及六个最大亚洲亚组的年均百分比变化趋势。我们将这些比率与非西班牙裔白人进行了比较。我们按性别、出生地和结直肠癌位置（结肠与直肠）对比率进行了分层。
亚洲亚组在结直肠癌死亡率方面表现出显著的异质性。相对于非西班牙裔白人组，亚裔印度裔美国人的死亡率最低[女性SMR = 0.3；95%置信区间（CI），0.3 - 0.3，男性SMR = 0.3；95% CI，0.3 - 0.3]，而日裔美国人的死亡率最高（女性SMR = 0.9；95% CI，0.8 - 0.9，男性SMR = 0.9；95% CI，0.9 - 1.0）。华裔、菲律宾裔、韩裔和越南裔美国人的死亡率介于亚裔印度裔和日裔之间。在研究期间，大多数亚洲亚组的死亡率稳定或下降。然而，在此期间，韩裔和越南裔的结直肠癌死亡率均有所上升。到研究期结束时，韩裔美国人的结直肠癌死亡率在所有亚洲亚组中最高。
亚洲亚组在结直肠癌死亡率模式上表现出异质性，强调了在癌症研究中进行细分的必要性。
我们的研究提供了细分的亚洲亚组结直肠癌死亡率数据，这可能有助于开展有针对性的风险降低工作。
