Project Summary

This special initiative application represents innovative research to improve current understandings of cancer disparities and the disproportionate cancer burden among U.S. Pacific Islanders. Our research will focus on Native Hawaiians, Guamanian/Chamorros and Samoans, three Pacific Islander ethnic minority groups that face significant risks of being medically underserved. Understudied in the broader health disparity literature, these distinct minority groups share common traits. As U.S. citizens (Native Hawaiians and Guamanian/Chamorros) and immigrants of the U.S. territories including the independent Samoa, they face high levels of under-employment and poverty, frequently lack health insurance, and often suffer from untreated illness. Moreover the rarity of Pacific Islander respondents in national health surveys has led many researchers to declare it impossible to examine Pacific Islander health needs in a statistically robust manner using periodic surveys that measure the nation's health. The artificial grouping of Pacific Islanders with Asians has created additional measurement problems due to the high level of heterogeneity with the Asian Pacific Islander (API) category. The specific aims of this study are: 1) to describe cancer incidence and mortality among Pacific Islanders living in Hawaii and California; 2) Identify disparities in cancer incidence and mortality for their three subgroups; and 3) Compare cancer incidence and mortality among Pacific Islanders in Hawaii and California. The study involves analysis of population based data?the National Cancer Institute Surveillance Epidemiology and End Results (SEER) cancer registry system, the National Center for Health Statistics Mortality Detail Files (MDFs), U.S. Census summary files and a specialized county-level contextual data file that can be linked to these other data sets to reflect community effects. Initially cancer incidence rates and cancer related mortality rates will be calculated using the cohort-component approach, generating the annual intercensal population estimates currently lacking for both the SEERS and the NCHS data. Age cohort differentials across the lifecourse of cancer care and risk of mortality will be examined using life table analysis and age standardized comparisons across groups by gender and geography. Logistic and multiple regression models are employed in the analysis of socioeconomic factors associated with differences in cancer incidence and mortality. To determine survival patterns for leading cancer sites and level of cancer care the proposed study will employ life-table techniques, distributional hazard and Cox models. The proposed research will establish useful baseline information on cancer incidence and mortality, and lay the foundation for meaningful systematic interventions to reduce cancer disparities among this underserved population.

Funding

American Cancer Society

Investigators

  • Sela V. Panapasa

Project Period

2012-01-01 - 2015-12-31