Breast cancer rates rise among AAPI women

In 2021, around 11,000 AAPI women were diagnosed with breast cancer and roughly 1,500 died. According to age-adjusted data from NIH, around 55 of every 100,000 AAPI women under 50 were diagnosed with breast cancer in 2021, a rate higher than Black and Hispanic women and around equal to the rate for white women.

In addition, between 2000 and 2021, the new rate of breast cancer cases increased by around 52% among AAPI women under 50, 33% for AAPI women ages 50 to 64, and 43% for AAPI women 65 and older. By comparison, breast cancer rates for women of all ages, races, and ethnicities increased by 3% during that time.

While women in most racial and ethnic groups are seeing significant declines in breast cancer death rates, roughly 12 out of every 100,000 AAPI women of any age died from breast cancer last year, which is around the same death rate as 2000, according to age-adjusted data from CDC. During that same period, the breast cancer death rate among all women dropped 30%.

Between 2018 and 2023, CDC data shows that nearly 9,000 Asian American women died from breast cancer, compared to around 500 Native Hawaiian and Pacific Islander women. However, breast cancer death rates were 116% higher among Native Hawaiian and Pacific Islander women than they were among Asian American women during that period.

NIH data has shown that rates of pancreatic, thyroid, colon, and endometrial cancer, as well as non-Hodgkin lymphoma, have also significantly increased among AAPI women under the age of 50. However, breast cancer is much more common among young AAPI women than any of those other types of cancer. This is especially concerning, as young women are more likely to face a more aggressive form of breast cancer with higher mortality rates, according to the Breast Cancer Research Foundation.

"We're seeing somewhere almost around a 4% per-year increase," said Scarlett Gomez, a professor and epidemiologist at the University of California, San Francisco's Helen Diller Family Comprehensive Cancer Center. "We're seeing even more than the 4% per-year increase in Asian/Pacific Islander women less than age 50."

Experts struggle to explain the trend

Experts have noticed the trend of rising breast cancer rates among AAPI women and suspect the cause behind it is likely complicated, ranging from cultural shifts to pressure-filled lifestyles.

Helen Chew, director of the Clinical Breast Cancer Program at UC Davis Health, said the AAPI diaspora is so broad and diverse that a simple explanation for the increase in breast cancer rates isn't obvious.

"It's a real trend," Chew said, adding that "it is just difficult to tease out exactly why it is. Is it because we're seeing an influx of people who have less access to care? Is it because of many things culturally where they may not want to come in if they see something on their breast?"

Gomez noted there isn't enough research yet to know what's causing the recent spike in breast cancer, and that the answer could involve multiple risk factors over a long period of time.

"One of the hypotheses that we're exploring there is the role of stress," she said. " We're asking all sorts of questions about different sources of stress, different coping styles throughout the lifetime."

Gomez added that it's likely not just an increase in screening. "We looked at trends by stage at diagnosis and we are seeing similar rates of increase across all stages of disease," she said.

Veronica Setiawan, a professor and epidemiologist at the Keck School of Medicine at the University of Southern California, said the trend could be related to Asian immigrants adopting some lifestyles that increase their risk.

"Asian women, American women, they become more westernized so they have their puberty younger now — having earlier age at [the first menstrual cycle] is associated with increased risk," Setiawan said. "Maybe giving birth later, we delay childbearing, we don't breastfeed — those are all associated with breast cancer risks." (Reese, KFF Health News, 9/4)

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