Aayush Visaria, National SAMSA’s research chair and MS4 at Rutgers New Jersey Medical School, recently reviewed the following study published in the The International Journal of Cancer: “Breast cancer among Asian Indian and Pakistani Americans: A surveillance, epidemiology and end results‐based study.”

There are over 5 million (and counting) South Asians currently in the United States. Yet, there is still very little knowledge on common disease incidence, trajectories, and outcomes among South Asians in the US. Satagopan et al., in a study published in the International Journal of Cancer (Oct. 2020), further investigated breast cancer, the leading cause of cancer and 2nd leading cause of cancer mortality, in Asian Indians and Pakistani American (AIPAs) women aged 30 and above using data from the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) Program. 

The researchers found that breast cancer incidence in AIPA women was lower than in non-Hispanic White women; however, AIPA women with breast cancer were more likely to be diagnosed at a younger age and with more advanced staging. Interestingly, despite this increased proportion of aggressive cancers in AIPAs, breast cancer mortality was lower in AIPAs compared to non-Hispanic White women.

According to study authors, this decrease in mortality and incidence is difficult to explain due to lack of information on lab data, estrogen levels, medication use, sociobehavioral characteristics, and unique cultural/acculturation factors. Increased follow-up with AIPA women and qualitative & quantitative studies in AIPAs with breast cancer can better clarify the reasons for these ethnic differences. Further studies are also needed to shed light on reasons for published low mammography screening rates in AIPAs.

As with any study, there were several limitations. First, the AIPA population was younger than the non-Hispanic White population, and there were significantly more non-Hispanic White breast cancer cases than AIPA cases. The registries included in the database the authors used only cover 28% of the entire US population, which may not accurately represent AIPAs, as a whole, in the US.

If you are interested in working with the SEER database, it is publicly available through the SEER website (https://seer.cancer.gov/data/), along with a software called SEER*Stat to assist with data analysis. Feel free to reach out to National SAMSA at nationalsamsa@gmail.com if you have any questions or have ideas on further research in this area.

Satagopan JM, Stroup A, Kinney AY, Dharamdasani T, Ganesan S, Bandera EV. Breast cancer among Asian Indian and Pakistani Americans: A surveillance, epidemiology and end results‐based study. International Journal of Cancer. 

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