State level variations in the diagnosis of breast cancer among Pacific Islander women in California and Hawaii

Background/Significance: The provision of care for women is particularly challenging among small and underserved populations such as Native Hawaiians and Pacific Islanders (NHPI). Language barriers, limited insurance and poverty often negatively impact the early screening cancers, costing precious time to effectively manage the cancer at the earliest point possible. An additional challenge is the lack of health information on cancer risks among small populations, limiting the ability of care providers to anticipate the needs facing groups.

Objective/Purpose: The paper illustrates how variation among NHPI population groups impacts the incidence of breast cancer diagnosis and how this risk varies by place of residence. The analysis measures regional variation in overall cancer and breast cancer risks among Native Hawaiian and Pacific Islander women in Hawaii and California, states with a high concentration of NHPI populations. We measure the incidence of breast cancer among NHPI women relative to other racial groups and show how risks differ between the two states suggesting environmental variation in observed incidence.

Methods: Using SEER data for the 2000 to 2010 time period we calculate overall cancer and breast cancer incidence among NHPI women in Hawaii and California and compare them to other racial groups.

Results: Regardless of NHPI ethnicity, women face a greater risk of being diagnosed with any cancer while those living in the state of Hawaii faced greater risks of breast cancer. Their risk also varies significantly from rates experienced by whites and blacks during the 2000 to 2010 time period.

Discussion/Conclusions: These findings help providers better understand the risks of cancer among women in small and often underserved minority populations, particularly NHPI women and how these risks can vary markedly by place of residence.