Christina Kashiwada’s breast cancer diagnosis at 36 years old was a jarring experience that highlighted a concerning trend: the rising incidence of breast cancer among Asian American and Pacific Islander (AAPI) women. Kashiwada, a civil engineer from Sacramento, California, initially brushed off a small, itchy lump in her breast, but a relative’s insistence led her to get a mammogram. The diagnosis was stage 3 breast cancer, a revelation that took her by surprise given her age and generally healthy lifestyle.
The Increasing Incidence
Recent federal data indicates a troubling rise in breast cancer diagnoses among AAPI women. In 2021, about 55 of every 100,000 AAPI women under 50 were diagnosed with breast cancer, surpassing rates for Black and Hispanic women and aligning with rates for white women. From 2000 to 2021, the rate of new breast cancer cases among AAPI women under 50 surged by about 52%, with significant increases in other age groups as well. This rise contrasts sharply with the overall 3% increase in breast cancer rates for women of all ages and ethnicities during the same period.
The Complexity of the Issue
Researchers are grappling with the causes behind this increase, which appears to be influenced by a range of factors. Helen Chew, director of the Clinical Breast Cancer Program at UC Davis Health, notes that the AAPI diaspora is extremely diverse, complicating efforts to pinpoint the exact reasons behind the rising rates. Cultural factors and access to healthcare are potential contributors, but no clear explanation has emerged.
Scarlett Gomez, an epidemiologist at the University of California-San Francisco, suggests that stress and lifestyle changes might be factors. There is ongoing research into how different sources of stress and coping mechanisms might impact cancer risk. Meanwhile, Veronica Setiawan of the Keck School of Medicine points to Westernized lifestyles, such as earlier puberty and delayed childbearing, as potential risk factors.
Disparities in Outcomes
The increase in breast cancer rates among AAPI women is accompanied by persistent disparities in outcomes. While breast cancer death rates have generally declined among women of various ethnicities, the death rate among AAPI women has remained relatively stable. For instance, about 12 of every 100,000 AAPI women died from breast cancer in 2023, similar to the rate in 2000. In comparison, the overall breast cancer death rate among women dropped by 30% during that period.
Among Pacific Islander women, breast cancer death rates are notably higher, with a 116% higher mortality rate compared to Asian American women.
Personal Impact and Awareness
For Kashiwada, the personal impact of breast cancer has been profound. She underwent a mastectomy, chemotherapy, radiation, and additional surgeries. Despite her ordeal, she has emerged with a renewed focus on awareness and prevention. She encourages other young women, particularly AAPI women, to remain vigilant and proactive about their health, regardless of their perceived invincibility.
“No matter how healthy you think you are, or you’re exercising, or whatever you’re doing,” Kashiwada says, “I would say it does not make you invincible or immune.”
The rising rates of breast cancer among AAPI women underline the need for continued research and awareness, emphasizing the importance of early detection and culturally sensitive healthcare approaches.
