We report cancer incidence, mortality, and stage distributions among Asians and Pacific Islanders (API) residing in the U.S. and note health disparities, using the cancer experience of the non-Hispanic white population as the referent group. New databases added to publicly available SEER*Stat software will enable public health researchers to further investigate cancer patterns among API groups.
Methods
Cancer diagnoses among API groups occurring from 1 January 1998 to 31 December 2002 were included from 14 Surveillance, Epidemiology, and End Results (SEER) Program state and regional population-based cancer registries covering 54% of the U.S. API population. Cancer deaths were included from the seven states that report death information for detailed API groups and which cover over 68% of the total U.S. API population. Using detailed racial/ethnic population data from the 2000 decennial census, we produced incidence rates centered on the census year for Asian Indians/Pakistanis, Chinese, Filipinos, Guamanians, Native Hawaiians, Japanese, Kampucheans, Koreans, Laotians, Samoans, Tongans, and Vietnamese. State vital records offices do not report API deaths separately for Kampucheans, Laotians, Pakistanis, and Tongans, so mortality rates were analyzed only for the remaining API groups.
Results
Overall cancer incidence rates for the API groups tended be lower than overall rates for non-Hispanic whites, with the exception of Native Hawaiian women (All cancers rate = 488.5 per 100,000 vs. 448.5 for non-Hispanic white women). Among the API groups, overall cancer incidence and death rates were highest for Native Hawaiian and Samoan men and women due to high rates for cancers of the prostate, lung, and colorectum among Native Hawaiian men; cancers of the prostate, lung, liver, and stomach among Samoan men; and cancers of the breast and lung among Native Hawaiian and Samoan women. Incidence and death rates for cancers of the liver, stomach, and nasopharynx were notably high in several of the API groups and exceeded rates generally seen for non-Hispanic white men and women. Incidence rates were lowest among Asian Indian/Pakistani and Guamanian men and women and Kampuchean women. Asian Indian and Guamanian men and women also had the lowest cancer death rates. Selected API groups had less favorable distributions of stage at diagnosis for certain cancers than non-Hispanic whites.
Conclusions
Possible disparities in cancer incidence or mortality between specific API groups in our study and non-Hispanic whites (referent group) were identified for several cancers. Unfavorable patterns of stage at diagnosis for cancers of the colon and rectum, breast, cervix uteri, and prostate suggest a need for cancer control interventions in selected groups. The observed variation in cancer patterns among API groups indicates the importance of monitoring these groups separately, as these patterns may provide etiologic clues that could be investigated by analytic epidemiological studies.
A goal of the U.S. Department of Health and Human Service’s Healthy People 2010 program is the elimination of health disparities that occur by race and ethnicity [1]. Health disparities have been defined as “…differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States [2].” This definition implies that a cancer health disparity exists when one segment of a population is found to have higher cancer rates (or some other measure of interest that indicates adverse conditions) than another population segment, or referent group. In this study, we report cancer incidence, mortality, and stage distributions among Asians and Pacific Islanders (API) residing in the U.S. and note health disparities, using the cancer experience of the non-Hispanic white population as the referent group. We identify specific API groups that may benefit from cancer control interventions or from further analytic epidemiologic research to follow up on etiologic leads.
Cancer surveillance systems, composed of high quality population-based (state or metropolitan area) central cancer registries, enable the monitoring of health disparities related to cancer incidence, mortality, patient survival, treatment, and quality of life [3]. The broad geographic coverage of national surveillance programs, such as the National Cancer Institute’s (NCI) Surveillance, Epidemiology, and End Results (SEER) Program which currently includes 26% of the U.S. population, facilitates the inclusion of more detailed racial/ethnic groups in such analyses by virtue of the large population base. Similarly, data from several state vital records offices that collect and report death information for an expanded set of racial/ethnic groups enables the identification of disparities in cancer mortality [4]. The lack of comparably-detailed racial/ethnic population estimates, however, often constrains U.S. health surveillance systems to report cancer rates for combined groups, such as API. This limitation obscures important differences in the cancer experience of heterogeneous populations [5‐7]. As a result, national statistics on cancer for Asian ethnic groups are not routinely available [8]. In this study, we have taken advantage of population data from the 2000 decennial census for detailed racial/ethnic groups, to calculate incidence and mortality rates for several specific API groups: Asian Indian/Pakistani, Chinese, Filipino, Guamanian, Native Hawaiian, Japanese, Kampuchean, Korean, Laotian, Samoan, Tongan, and Vietnamese (mortality data only are available for a subset of these groups—see Materials and methods). The databases used in these analyses can be accessed, under a data user agreement, from the SEER Web site [9].
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Material and methods
Study data
Information on new cancer diagnoses among API groups and non-Hispanic whites (referent group) occurring during the 5-year period from 1 January 1998 to 31 December 2002 was obtained from U.S. state and regional population-based cancer registries that participate in the NCI’s SEER Program. The reporting areas included in this analysis were: Atlanta, Detroit, Seattle/Puget Sound; and the states of California (registries for Los Angeles County, the Greater San Francisco Bay Area, and the rest of California), Connecticut, Hawaii, Iowa, Kentucky, Louisiana, New Jersey, New Mexico, and Utah. These registries cover 54% of the U.S. API population [10]. The specific API groups included in the incidence comparisons were Asian Indian/Pakistani (combined, due to SEER coding rules [11]), Chinese, Filipino, Guamanian, Native Hawaiian, Japanese, Kampuchean, Korean, Laotian, Samoan, Tongan, and Vietnamese. Approximately 7% of the API cancer cases were classified as “Asian not otherwise specified” (NOS) or “Pacific Islander NOS” and could not be included in the analysis. Only invasive cancers were analyzed, with the exception of the urinary bladder. Bladder cancers reported as either in situ or invasive were combined, since information in medical records needed to distinguish between these types of tumors is frequently either unavailable or unreliable [12]. The primary cancer type was coded according to the International Classification of Diseases for Oncology (ICD-O) edition in use at the time of diagnosis, converted to ICD-O Third Edition, and then categorized into cancer site groupings [13].
Cancer deaths occurring during the 1998–2002 study period were identified from all deaths reported to state vital records offices and consolidated by the National Vital Statistics System of the National Center for Health Statistics. The underlying cause of death was coded based on the version of the International Classification of Diseases (ICD) in use at the time of death. Deaths due to malignant neoplasm were then grouped to ensure comparability of disease categories across the ICD versions [13]. Since specification of expanded API racial categories on death certificates is currently required for seven states only (California, Hawaii, Illinois, New Jersey, New York, Texas, and Washington) and for nine API ethnic groups [14], we restricted our mortality analyses to these areas and groups (Table 1). Thus, the geographic coverage differs between the incidence and mortality analyses. Approximately 72% of the API population covered in the mortality analysis is also included in the incidence analysis. The seven states in the mortality analysis include over 68% of the total U.S. API population; representing 80% of Native Hawaiians, 79% of Filipinos, 77% of Japanese, 74% of Chinese and of Samoans, 65% of Koreans, 62% of Vietnamese, 61% of Guamanians, and 60% of Asian Indians [15]. Less than 0.1% of the API deaths were classified as “API NOS” and were excluded from the analysis. Deaths among non-Hispanic whites in these states are also included for purposes of comparison.
Table 1
Geographic areas included in cancer incidence and mortality rates for each racial/ethnic group, 1998–2002
Incidence rates
Mortality rates
CAa
CT
HI
IA
KY
LA
NJ
NM
UT
Atlanta metro
Detroit metro
Seattle–Puget Soundb
CA, HI, IL, NJ, NY, TX, and WA
Asian Indian or Pakistanic
X
X
–d
X
X
X
X
X
X
X
X
2
X
Chinese
X
X
X
X
X
X
X
X
X
X
X
9
X
Filipino
X
X
X
X
X
X
X
X
X
X
X
11
X
Guamanian
X
–e
X
–e
–e
–e
–e
–e
–e
–d
–d
6
X
Native Hawaiian
Xf
Xf
Japanese
X
X
X
X
X
X
X
X
X
X
X
9
X
Kampuchean
X
X
–e
–e
–e
–e
–e
–d
X
X
–d
6
–g
Korean
X
X
X
X
X
X
X
X
X
X
X
10
X
Laotian
X
X
X
X
–e
X
–e
–e
X
X
X
4
–g
Samoan
X
–e
X
–e
–e
–e
–e
–e
X
–d
–d
5
X
Tongan
X
–d
X
–d
–d
–d
–d
–d
X
–d
–d
1e
–g
Vietnamese
X
X
X
X
X
X
X
X
X
X
X
6
X
X—Indicates area was included in rate calculations
aIncludes cancer registries for Los Angeles, San Francisco/Oakland, San Jose/Monterey, and all remaining areas in California combined
bIndicates number of counties within the 11-county Seattle–Puget Sound area for which population estimates were NOT suppressed by the Census Bureau; and thus could be included in the incidence analyses
cIncidence rates calculated for combined group of Asian Indians & Pakistanis due to SEER program coding rules; mortality rates calculated only for Asian Indians due to NCHS coding rules
dArea not included in rate calculation due to supression of population data by Census Bureau
eArea not included in rate calculation due to small population size (<1,000); see materials and methods and Statistical analysis
fNative Hawaiian rates calculated only for the state of Hawaii
gMortality data not available from NCHS for these race/ethnic groups [3]
Data analysis
Cancer incidence and mortality rates were calculated for the combined 5-year study period, 1998–2002, as cases or deaths per 100,000 persons. The rates were age-adjusted to the 2000 U.S. standard population using 19 age groups (<1, 1–4, 5–9,…, 80–84, 85+). Rates and 95% confidence intervals (95% CI) [16] were generated using SEER*Stat software [http://www.seer.cancer.gov/seerstat/]. As rates based on small counts (either the number of diagnosed cases or deaths) tend to have poor reliability, they are not shown in tables if the case or death count is <16 [17, 18].
Detailed population data for specific API groups are available only from the decennial U.S. census. Therefore, we centered our study on the 2000 census and used the population counts, multiplied by five, as denominators for incidence and mortality rate calculations. In the 2000 census, individuals were able to indicate multiple race/ethnic responses on the census form [19]. These responses can be tabulated as two population values for detailed API groups; namely, the specific API group alone (counting those who self-identified with only one API group) and the specific API group alone or in combination with any other racial/ethnic groups (counting those who self-identified with either a single API group or with more than one racial/ethnic group, at least one of which was the specific API group of interest). Thus, the population counts for each of the specific API groups are not mutually exclusive. Population data for non-Hispanic whites consist of bridged single-race estimates available for each year from 1998 to 2002 [20, 21].
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Cancer registries and state vital records offices have also begun collecting and reporting multiple race and ethnicity information from medical records and death certificates. These sources, however, generally include only a single race or ethnicity designation (>99.95% of cancer diagnoses in SEER registries, data not shown). Therefore, only single race or ethnicity information was used for classifying cases and deaths in this study [11, 22].
Due to the lack of consistency between racial/ethnic information for the numerators (generally, single race from medical records or state vital records offices) and population denominators (either self-reported single race alone; or single race alone or in combination with other races), we calculated two rates for each cancer type, specific API group, and gender. These may be considered as representing a maximum rate (based on the smaller, single-race/ethnicity alone denominator) [23] and a minimum rate (based on the larger denominator that includes both multiple-race/ethnicity and single-race/ethnicity respondents) [24].
Census Bureau policy for Census 2000 data is to not disclose race/ethnicity-specific population counts below 100 for a particular geographic area [25]. Thus, we were unable to obtain comprehensive population denominators for some of the SEER reporting areas. When race/ethnicity-specific census population data were suppressed for an entire registry, the registry was excluded from rate calculations for that particular API group. However, when the census population data were suppressed for a subset of the counties within the Seattle/Puget Sound metropolitan area, we chose to calculate an incidence rate that included all remaining counties for which the race/ethnic-specific population data were not suppressed. This resulted in the exclusion of selected counties in Seattle/Puget Sound from incidence rate calculations for each of the API groups, with the exception of Filipinos (Table 1).
In addition, when a specific API population group in a SEER registry coverage area was less than 1,000 (based on single race/ethnicity alone population data), the data for that area was excluded from the cancer incidence rate calculations for that group. The rationale for this exclusion was that incidence rates for specific API groups in these registries with small populations were generally low; suggesting that misclassification of API ethnic information in medical records may be a bigger problem in these areas. Using this population threshold limited the number of geographic areas for Guamanians, Kampucheans, Laotians, Samoans, and Tongans (Table 1), but excluded just 1–2% of the total number of cancer cases in these groups. Cancer incidence and mortality rates for Native Hawaiians are reported only for the State of Hawaii due to the extensive efforts at the Hawaii Tumor Registry to classify all cancer patients with any native Hawaiian ancestry and because of the unique cultural and environmental characteristics of this group [26]. About 60% of the total U.S. Native Hawaiian population resides in Hawaii.
We examined the distribution of stage of disease at diagnosis for cancers of the colon and rectum, female breast, cervix uteri, and prostate using the SEER historical stage categories of localized, regional, and distant disease [27]. Due to changing medical practices in characterizing prostate cancers, we combined localized and regional prostate cancer cases for the analysis by stage. The age-adjusted distribution of stage at diagnosis for selected cancers was calculated in the following manner. An age-adjusted incidence rate was computed using the direct method for each particular stage group for a specific cancer site, it was then divided by the age-adjusted incidence rate for all stages combined, and the resulting proportion was converted to a percentage.
Results
To simplify the presentation of our findings, incidence, and mortality rates appearing in the tables are limited to those based on the single race/ethnicity denominators, with the exception of Native Hawaiian rates. Since the Hawaii Tumor Registry collects extensive multiple race/ethnicity information on their cancer patients and classifies a patient with any native Hawaiian ancestry as native Hawaiian, the most appropriate population denominator for a native Hawaiian rate is the one that includes Hawaiian alone or in any combination. Regardless of which denominators were used, the relative rankings of the cancer sites remained the same for all API groups, however, the magnitude of all the rates were reduced when larger denominators (i.e., population counts based on the specific API group alone or in combination with other any other racial/ethnic group), were used. Rates based on both single race/ethnicity and one or more race/ethnicity denominators are included as appendices. The appendices also include case counts and 95% CI for the rates.
Incidence rates: Men
The overall cancer incidence rates were highest among Native Hawaiian and Samoan men, due to high rates of prostate and lung cancers (Table 2), but they do not exceed the overall cancer rate for non-Hispanic white men (Table 4). Lung cancer incidence in Native Hawaiian men, however, was higher than that for non-Hispanic white men. Asian Indian/Pakistani and Guamanian men had the lowest overall cancer rates among the API groups, and Asian Indians/Pakistanis had relatively low rates for lung and colorectal cancers. Prostate cancer was the leading cancer in Asian Indian/Pakistani, Chinese, Filipino, Guamanian, Native Hawaiian, Japanese, and Samoan men, while lung cancer rates were highest in Kampuchean, Korean, Laotian, Tongan, and Vietnamese men. Colorectal cancer was among the top three cancers in Asian Indian/Pakistani, Chinese, Filipino, Native Hawaiian, Japanese, Korean, and men; whereas liver cancer was among the top three in Kampuchean, Laotian, Samoan, and Vietnamese men. Japanese men had the highest colorectal cancer rate (75.9 per 100,000; 95% CI: 71.9, 80.2) and this exceeded the rate in non-Hispanic white men. Among Laotian men, incidence rates for lung, liver, and stomach cancers all exceeded the rate for prostate cancer; in fact, their prostate cancer rate (30.9; 95% CI: 18.2, 51.9) was lowest among the API groups in our study. Stomach cancer was among the top five cancers in all API groups, with the exception of Asian Indian/Pakistani and Filipino men, but ranked much lower in non-Hispanic white men (Appendix Table 1). Rates of stomach cancer were particularly high for Korean (50.0; 95% CI: 44.6, 56.2) and Samoan men (53.0; 95% CI: 33.2, 86.1). Liver cancer was also among the top five cancers in Chinese, Filipino, Kampuchean, Korean, Laotian, Samoan, and Vietnamese men. The liver cancer rate was highest in Laotian men (79.4; 95% CI: 60.7, 105.0). Rates for nasopharyngeal cancer were highest in Chinese and Vietnamese men, but not among the top five cancers for any group, and greatly exceeded the rate in non-Hispanic white men (Appendix Table 1). Nasopharyngeal cancer may also have been high in other API groups, but the number of cases in our study were too small to produce reliable rates.
Table 2
Top five age-adjusted cancer incidence ratesa and 95% CI by Asian or Pacific Islander subgroup, 1998–2002: Men
Rank
Asian Indian or Pakistani
Chinese
Filipino
Rate
(95% CI)
Rate
(95% CI)
Rate
(95% CI)
All cancers
292.1
(277.3, 307.9)
All cancers
348.8
(341.5, 356.2)
All cancers
393.2
(385.0, 401.5)
1
Prostate
98.4
(90.0, 107.7)
Prostate
84.8
(81.2, 88.5)
Prostate
121.9
(117.3, 126.6)
2
Lung
30.8
(25.7, 36.8)
Colorectum
54.0
(51.2, 57.0)
Lung
72.5
(69.0, 76.1)
3
Colorectum
23.1
(19.3, 27.9)
Lung
53.0
(50.1, 56.0)
Colorectum
50.4
(47.5, 53.4)
4
Non-Hodgn
15.8
(12.5, 20.1)
Liver
24.0
(22.1, 25.9)
Non-Hodgn
19.4
(17.7, 21.4)
5
Bladder
15.8
(12.1, 20.5)
Stomach
18.3
(16.6, 20.2)
Liver
17.2
(15.5, 19.0)
Guamanian
Native Hawaiianb
Japanese
All cancers
252.1
(189.8, 336.7)
All cancers
531.6
(503.7, 561.1)
All Cancers
422.4
(412.8, 432.3)
1
Prostate
131.5
(85.0, 202.4)
Prostate
119.7
(106.1, 135.1)
Prostate
115.0
(110.1, 120.1)
2
nr
Lung
109.8
(97.4, 123.9)
Colorectal
75.9
(71.9, 80.2)
3
nr
Colorectal
65.7
(56.1, 77.1)
Lung
49.8
(46.6, 53.3)
4
nr
Bladder
21.2
(15.3, 29.1)
Stomach
29.3
(26.9, 32.1)
5
nr
Non-Hodgn
19.6
(14.8, 26.3)
Bladder
22.9
(20.8, 25.4)
Kampuchean
Korean
Laotian
All cancers
372.0
(325.3, 425.5)
All cancers
372.6
(357.4, 388.4)
All Cancers
407.2
(360.7, 460.3)
1
Lung
82.6
(60.1, 112.6)
Lung
61.1
(54.8, 68.2)
Lung
87.3
(64.9, 117.4)
2
Liver
49.1
(36.3, 68.5)
Colorectum
55.9
(50.2, 62.2)
Liver
79.4
(60.7, 105.0)
3
Prostate
39.7
(25.0, 62.2)
Prostate
55.7
(49.8, 62.3)
Stomach
33.1
(19.1, 55.8)
4
Colorectum
30.0
(18.3, 49.5)
Stomach
55.0
(44.6, 56.2)
Prostate
30.9
(18.2, 51.9)
5
Stomach
23.8
(12.1, 44.3)
Liver
35.9
(31.6, 40.8)
Colorectum
30.2
(19.4, 48.8)
Samoan
Tongan
Vietnamese
All cancers
566.7
(498.8, 645.5)
All cancers
428.8
(329.9, 555.9)
All Cancers
374.3
(358.5, 390.9)
1
Prostate
144.1
(110.0, 190.4)
Lung
107.0
(55.2, 193.0)
Lung
72.3
(65.3, 80.2)
2
Lung
111.9
(84.4, 151.1)
Prostate
85.0
(44.5, 157.4)
Prostate
59.1
(52.8, 66.3)
3
Liver
54.5
(35.2, 86.9)
nr
Liver
55.5
(49.9, 62.0)
4
Stomach
53.0
(33.2, 86.1)
nr
Colorectum
41.2
(36.1, 47.1)
5
Colorectum
43.1
(26.6, 72.8)
nr
Stomach
25.6
(21.2, 30.9)
aRates are average annual per 100,000 age-adjusted to the 2000 U.S. standard population for the following SEER areas: Atlanta, Detroit, Seattle/Puget Sound; and the states of California (registries for Los Angeles County, the Greater San Francisco Bay Area, and the rest of California), Connecticut, Hawaii, Iowa, Kentucky, Louisiana, New Jersey, New Mexico, and Utah
bRates for Native Hawaiians are calculated using the one or more race/ethnicities population denominators for Hawaii only (See Materials and methods)
Abbreviations: Lung = lung and bronchus; Liver = liver and intrahepatic bile duct; Non-Hodgn = non-Hodgkin lymphoma
Incidence rates: Women
Native Hawaiian, Samoan, and Tongan women had the highest overall cancer incidence rates, while Asian Indian/Pakistani, Guamanian, and Kampuchean women had the lowest rates (Table 3). The cancer rate in Native Hawaiian women even exceeds that of non-Hispanic white women (Table 4). Breast cancer was the leading cancer in each female API group with the exception of Laotian women, for whom lung cancer had the highest age-adjusted incidence rate and breast cancer had the second highest rate, though the variability associated with each of these rates was large. Breast cancer incidence was highest among Native Hawaiian women (175.8; 95% CI: 163.0, 189.4) and exceeded the rate in non-Hispanic white women. Lung cancer was among the top four cancers in every female API group and Native Hawaiian women had the highest rate (69.7; 95% CI: 61.2, 79.1). Colorectal cancer was one of the top four cancers in all groups for whom there were sufficient data. Japanese women, similar to the men, had the highest colorectal cancer rate (51.9; 95% CI: 49.1, 55.0) among the racial/ethnic groups, even exceeding the rate in non-Hispanic white women. Cervical cancer was among the top five cancers in Kampuchean, Laotian, Samoan, and Vietnamese women and their rates exceeded that for non-Hispanic white women (Appendix Table 1). Endometrial cancer was among the top four leading cancers for all groups with the exception of Kampuchean, Korean, Laotian, and Vietnamese women. Liver cancer was the fifth leading cancer in Kampuchean, Korean, Laotian, and Vietnamese women. Stomach cancer was among the top five cancers for Chinese, Japanese, and Korean women, and greatly exceeded the rate in non-Hispanic white women. As observed in men, nasopharyngeal cancer rates were highest in Chinese and Vietnamese women, while small numbers of cases precluded an evaluation of the rates in many of the other API groups (Appendix Table 1).
Table 3
Top five age-adjusted cancer incidence ratesa and 95% CI by Asian or Pacific Islander subgroup, 1998–2002: Women
Rank
Asian Indian or Pakistani
Chinese
Filipina
Rate
(95% CI)
Rate
(95% CI)
Rate
(95% CI)
All cancers
238.1
(226.7, 250.2)
All cancers
270.4
(264.7, 276.2)
All cancers
291.1
(285.3, 297.1)
1
Breast
82.1
(76.1, 88.8)
Breast
77.6
(74.6, 80.6)
Breast
100.4
(97.1, 103.8)
2
Colorectum
18.8
(15.5, 23.0)
Colorectum
40.2
(38.0, 42.5)
Colorectum
29.4
(27.5, 31.4)
3
Endometrium
13.5
(10.9, 16.7)
Lung
29.7
(27.8, 31.7)
Lung
26.0
(24.1, 27.9)
4
Lung
13.1
(10.2, 16.9)
Endometrium
12.0
(10.9, 13.3)
Endometrium
18.6
(17.2, 20.1)
5
Ovary
12.0
(9.7, 15.1)
Stomach
11.1
(10.0, 12.4)
Thyroid
17.7
(16.4, 19.2)
Guamanian
Native Hawaiianb
Japanese
All cancers
175.6
(132.7, 233.8)
All cancers
488.5
(466.5, 511.3)
All Cancers
342.4
(334.5, 350.2)
1
Breast
45.0
(28.3, 78.1)
Breast
175.8
(163.0, 189.4)
Breast
126.5
(121.7, 131.5)
2
Lung
40.7
(22.4, 76.4)
Lung
69.7
(61.2, 79.1)
Colorectum
51.9
(49.1, 55.0)
3
nr
Colorectum
44.0
(37.3, 51.6)
Lung
24.7
(22.8, 26.8)
4
nr
Endometrium
37.5
(31.9, 44.1)
Endometrium
20.4
(18.5, 22.6)
5
nr
Pancreas
18.6
(14.3, 23.9)
Stomach
15.0
(13.6, 16.8)
Kampuchean
Korean
Laotian
All cancers
212.3
(185.9, 242.4)
All cancers
254.5
(245.2, 264.1)
All Cancers
297.9
(263.0, 337.1)
1
Breast
38.2
(28.3, 51.8)
Breast
53.5
(49.7, 57.6)
Lung
44.4
(31.2, 62.3)
2
Lung
24.6
(15.6, 37.8)
Colorectum
35.9
(32.3, 39.8)
Breast
36.9
(26.5, 51.5)
3
Colorectum
21.1
(13.1, 33.2)
Lung
27.5
(24.3, 31.0)
Colorectum
27.5
(17.1, 42.7)
4
Cervix Uteri
15.3
(9.3, 25.3)
Stomach
26.3
(23.3, 29.7)
Cervix Uteri
24.8
(16.0, 38.0)
5
Liver
14.1
(7.6, 24.9)
Liver
14.4
(12.2, 17.0)
Liver
23.1
(14.5, 36.4)
Samoan
Tongan
Vietnamese
All cancers
472.0
(421.5, 528.6)
All cancers
504.7
(414.1, 616.6)
All Cancers
270.6
(259.6, 282.2)
1
Breast
102.5
(81.7, 129.5)
Breast
118.0
(78.1, 181.2)
Breast
52.8
(48.6, 57.5)
2
Endometrium
66.1
(50.3, 88.2)
Endometrium
91.2
(56.4, 150.1)
Lung
34.4
(30.3, 39.1)
3
Lung
56.9
(39.6, 81.3)
nr
Colorectum
33.3
(29.3, 37.8)
4
Colorectum
38.6
(24.1, 60.5)
nr
Cervix Uteri
16.8
(14.3, 19.8)
5
Cervix Uteri
18.1
(10.6, 32.7)
nr
Liver
16.8
(14.0, 20.1)
aRates are average annual per 100,000 age-adjusted to the 2000 U.S. standard population for the following SEER areas: Atlanta, Detroit, Seattle/Puget Sound; and the states of California (registries for Los Angeles County, the Greater San Francisco Bay Area, and the rest of California), Connecticut, Hawaii, Iowa, Kentucky, Louisiana, New Jersey, New Mexico, and Utah
bRates for Native Hawaiians are calculated using the one or more race/ethnicities population denominators for Hawaii only (See Materials and methods)
Abbreviations: Lung = lung and bronchus; Liver = liver and intrahepatic bile duct; Endometrium = corpus uterus, NOS
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Stage distribution
Age-adjusted percentage stage distributions are shown for cancers of the colon and rectum, female breast, cervix uteri, and prostate in Figs. 1a–d, 1e. Laotian, Samoan, and Vietnamese men had lower percentages of colorectal cancers diagnosed at an early (localized) stage relative to the other API groups and to non-Hispanic whites. The total number of cases was fairly small, however, for Laotian (n = 30) and Samoan (n = 31) men. Among women, Laotians again had a lower percentage of localized stage diagnoses, but this was also based on a small total number of colorectal cancers (n = 24). For female breast cancer, Laotian, Samoan, and Tongan women had a smaller percentage of cases diagnosed at localized stage than the other groups. The total number of breast cancer cases in each of these groups was 45, 94, and 35, respectively. Kampuchean, Laotian, and Samoan women had smaller percentages of cervical cancers diagnosed at localized stage (total number of cervical cancers = 22, 28, and 19, respectively). Comparisons of the stage distribution of prostate cancer across the API groups indicated that Kampuchean, Samoan, and Tongan men had smaller percentages of local/regional cancers than the other groups, though the total number of cases was limited (n = 27, 77, and 16, respectively).
Fig. 1
(a) Age-adjusted percentage distributions of stage at diagnosis for colorectal cancer,1998–2002: Men. (b) Age-adjusted percentage distributions of stage at diagnosis for colorectal cancer, 1998–2002: Women. (c) Age-adjusted percentage distributions of stage at diagnosis for breast cancer, 1998–2002: Women. (d) Age-adjusted percentage distributions of stage at diagnosis for cervix uteri cancer, 1998–2002: Women. (e) Age-adjusted percentage distributions of stage at diagnosis for prostate cancer, 1998–2002: Men
×
Mortality rates: Men
The overall cancer death rates were highest among Samoan and Native Hawaiian men (Table 5) and, unlike the incidence rates, exceeded the overall cancer death rate for non-Hispanic white men (Table 4). Asian Indian men had the lowest overall cancer mortality rate among the API groups, largely due to relatively low rates for lung and colorectal cancers. Lung and bronchus cancer had the highest age-adjusted death rate for each Asian ethnic group. Native Hawaiian men had the highest lung cancer rate (87.7 per 100,000; 95% CI: 76.4, 100.7), and exceeded the rate in non-Hispanic white men (72.2 per 100,000; 95% CI: 71.8, 72.7). Prostate cancer mortality was among the top three causes of cancer death in Asian Indian, Filipino, Native Hawaiian, and Samoan men. Samoan men had the highest rate (36.2 per 100,000; 95% CI: 18.9, 64.4), but it is based on relatively few deaths and its confidence interval includes the rates seen for native Hawaiian and non-Hispanic white men. Colorectal cancer was among the top three causes of cancer death in Chinese, Filipino, Native Hawaiian, and Japanese men. Samoans had the highest rate (31.6 per 100,000; 95% CI: 17.2, 56.0). Liver cancer was in the top four causes of cancer death for all male Asian ethnic groups, except, Native Hawaiians and Japanese. Samoans also had the highest rate for this site (32.9 per 100,000; 95% CI: 19.3, 56.1). Stomach cancers were in the top four causes of cancer death for all male Asian ethnic groups, except Asian Indians and Filipinos. Samoans had the highest rate for this site as well (40.9 per 100,000; 95% CI: 24.1, 67.6).
Table 4
Top five age-adjusted cancer rates and 95% CI for non-Hispanic white men and women, 1998–2002
Rank
Men
Women
Rate
(95% CI)
Rate
(95% CI)
Incidencea
All cancers
587.0
(585.6, 588.5)
All cancers
448.5
(447.3, 449.6)
1
Prostate
170.0
(169.3, 170.8)
Breast
145.2
(144.5, 145.8)
2
Lung
89.2
(88.7, 89.8)
Lung
59.0
(58.6, 59.4)
3
Colorectum
65.6
(65.2, 66.1)
Colorectum
47.6
(47.2, 47.9)
4
Bladder
43.0
(42.6, 43.4)
Endometrium
26.0
(25.7, 26.2)
5
Melanoma
29.3
(29.0, 29.6)
Melanoma
19.3
(19.0, 19.5)
Mortalityb
All cancers
241.3
(240.5, 242.1)
All cancers
171.7
(171.1, 172.2)
1
Lung
72.2
(71.8, 72.7)
Lung
44.5
(44.2, 44.8)
2
Prostate
27.7
(27.4, 28.0)
Breast
27.8
(27.5, 28.0)
3
Colorectum
24.6
(24.3, 24.8)
Colorectum
17.3
(17.1, 17.5)
4
Pancreas
12.6
(12.4, 12.8)
Ovary
9.8
(9.7, 9.9)
5
Non-Hodgkin
10.6
(10.5, 10.8)
Pancreas
9.5
(9.4, 9.6)
aRates are average annual per 100,000 age-adjusted to the 2000 U.S. standard population for the following SEER areas: Atlanta, Detroit, Seattle/Puget Sound; and the states of California (registries for Los Angeles County, the Greater San Francisco Bay Area, and the rest of California), Connecticut, Hawaii, Iowa, Kentucky, Louisiana, New Jersey, New Mexico, and Utah
bRates are average annual per 100,000 age-adjusted to the 2000 U.S. standard population for the following States: California, Hawaii, Illinois, New Jersey, New York, Texas, and Washington
Abbreviations: Lung = lung and bronchus; Endometrium = corpus uterus, NOS; Non-Hodgn = non-Hodgkin lymphoma
Table 5
Top five age-adjusted cancer mortality ratesa and 95% CI by Asian or Pacific Islander subgroup, 1998–2002: Men
Rank
Korean
Samoan
Vietnamese
Rate
(95% CI)
Rate
(95% CI)
Rate
(95% CI)
All cancers
82.8
(75.7, 90.5)
All cancers
167.8
(163.4, 172.4)
All Cancers
155.6
(150.6, 160.8)
1
Lung
17.2
(14.1, 21.1)
Lung
47.0
(44.78, 49.5)
Lung
47.9
(45.7, 50.8)
2
Prostate
10.6
(7.8, 14.2)
Liver
20.3
(18.8, 21.9)
Prostate
17.8
(16.1, 19.8)
3
Pancreas
5.8
(4.1, 8.3)
Colorectum
19.5
(18.0, 21.2)
Colorectum
16.1
(14.6, 17.8)
4
Liver
5.3
(3.6, 7.7)
Stomach
11.7
(10.5, 12.9)
Liver
11.3
(10.1, 12.7)
5
Leukemia
4.8
(3.3, 7.1)
Prostate
10.4
(9.2, 11.7)
Non-Hodgkin
9.1
(7.9, 10.4)
Guamanian
Native Hawaiianb
Japanese
All cancers
147.0
(106.5, 201.8)
All cancers
263.7
(243.7, 285.4)
All Cancers
173.7
(167.7, 179.9)
1
Lung
47.4
(28.4, 81.0)
Lung
87.7
(76.4, 100.7)
Lung
39.5
(36.7, 42.5)
2
nr
Colorectum
26.9
(20.8, 34.9)
Colorectum
25.8
(23.6, 28.3)
3
nr
Prostate
21.9
(15.7, 30.1)
Stomach
16.6
(14.8, 18.7)
4
nr
Stomach
14.1
(9.9, 20.2)
Prostate
15.2
(13.5, 17.3)
5
nr
Liver
11.8
(7.9, 17.7)
Pancreas
12.2
(10.6, 14.0)
Korean
Samoan
Vietnamese
All cancers
196.5
(186.2, 207.4)
All cancers
293.9
(247.6, 348.6)
All Cancers
159.9
(149.9, 170.7)
1
Lung
50.6
(45.3, 56.2)
Lung
74.0
(53.6, 102.9)
Lung
43.9
(38.7, 49.9)
2
Stomach
31.5
(27.5, 36.0)
Stomach
40.9
(24.1, 67.6)
Liver
33.8
(29.6, 38.8)
3
Liver
26.3
(23.0, 30.2)
Prostate
36.2
(18.9, 64.4)
Stomach
12.7
(9.8, 16.4)
4
Colorectum
17.6
(14.6, 21.3)
Liver
32.9
(19.3, 56.1)
Pancreas
8.9
(6.6, 11.9)
5
Pancreas
11.4
(9.1, 14.3)
Colorectum
31.6
(17.2, 56.0)
Colorectum
8.8
(6.6, 11.7)
aRates are average annual per 100,000 age-adjusted to the 2000 U.S. standard population for the following States: California, Hawaii, Illinois, New Jersey, New York, Texas, and Washington
bRates for Native Hawaiians are calculated using the one or more race/ethnicities population denominators for Hawaii only (See Materials and methods)
Abbreviations: Lung = lung and bronchus; Liver = liver and intrahepatic bile duct; Non-Hodgkin = non-Hodgkin lymphoma
Mortality rates: Women
Samoan and Native Hawaiian women had the highest overall cancer death rates (Table 6), and even exceed the cancer mortality rate for non-Hispanic white women (Table 4). Asian Indian women had the lowest overall cancer death rate. Lung cancer was the leading cause of cancer death in each female API group, with the exception of Asian Indian women, for whom breast cancer had the highest age-adjusted rate (Table 6). Native Hawaiian women had the highest lung cancer death rate of all the API groups (47.6 per 100,000; 95% CI: 40.6, 55.6), but the confidence interval included the rate seen for non-Hispanic white women. Breast cancer was among the top three cancer causes of death for each female Asian ethnic group, except Koreans, where it was in the top five. Samoan and native Hawaiian women had the highest breast cancer death rates among the API groups. Colorectal cancer was among the top four cancers in every female API group, except Guamanian and Samoan women, for whom the data were too sparse to evaluate for this cancer. Liver cancer was among the top four cancer causes of death in Chinese, Korean, and Vietnamese women and their rates exceed the liver cancer mortality rate for non-Hispanic white women (Appendix Table 2). Stomach cancer was among the top five cancer causes of death for Chinese, Native Hawaiian, Japanese, Korean, and Vietnamese women and their rates exceeded the rate in non-Hispanic white women (Appendix Table 2). The cervical cancer death rate in Vietnamese women, though not among the top five cancers, exceeded the rate in non-Hispanic white women (Appendix Table 2).
Table 6
Top five age-adjusted cancer mortality ratesa and 95% CI by Asian or Pacific Islander subgroup, 1998–2002: Women
Rank
Asian Indian
Chinese
Filipina
Rate
(95% CI)
Rate
(95% CI)
Rate
(95% CI)
All cancers
67.4
(62.2, 73.1)
All cancers
107.7
(104.5, 110.9)
All Cancers
96.1
(92.8, 99.5)
1
Breast
11.2
(9.4, 13.5)
Lung
23.8
(22.4, 25.4)
Breast
17.2
(15.9, 18.6)
2
Lung
6.4
(4.8, 8.5)
Colorectum
12.8
(11.7, 13.9)
Lung
17.2
(15.8, 18.7)
3
Colorectum
5.3
(3.8, 7.3)
Breast
12.3
(11.3, 13.4)
Colorectum
9.0
(8.0, 10.1)
4
Ovary
5.0
(3.7, 6.8)
Liver
7.4
(6.5, 8.2)
Pancreas
6.3
(5.4, 7.2)
5
Pancreas
3.5
(2.4, 5.2)
Stomach
7.3
(6.5, 8.2)
Ovary
5.6
(4.9, 6.5)
Guamanian
Native Hawaiianb
Japanese
All cancers
98.5
(69.5, 138.8)
All cancers
198.9
(184.4, 214.4)
All Cancers
117.0
(112.9, 121.4)
1
nr
Lung
47.6
(40.6, 55.6)
Lung
19.7
(18.1, 21.5)
2
nr
Breast
33.5
(27.9, 40.1)
Colorectal
15.3
(13.8, 17.0)
3
nr
Pancreas
16.8
(12.7, 21.8)
Breast
15.1
(13.6, 16.9)
4
nr
Colorectum
13.1
(9.5, 17.7)
Pancreas
10.6
(9.4, 12.1)
5
nr
Stomach
10.3
(9.5, 17.7)
Stomach
10.2
(9.0, 11.6)
Korean
Samoan
Vietnamese
All cancers
108.2
(102.6, 114.1)
All cancers
209.3
(176.5, 248.2)
All Cancers
97.8
(91.2, 104.9)
1
Lung
20.7
(18.2, 23.4)
Lung
42.0
(27.1, 63.7)
Lung
20.2
(17.1, 23.7)
2
Stomach
14.5
(12.5, 16.8)
Breast
36.2
(24.0, 54.9)
Liver
10.9
(8.8, 13.6)
3
Colorectum
12.1
(10.3, 14.2)
nr
Breast
7.6
(6.1, 9.5)
4
Liver
11.7
(9.9, 13.7)
nr
Colorectum
7.4
(5.6, 9.7)
5
Breast
7.8
(6.5, 9.3)
nr
Stomach
7.0
(5.3, 9.2)
aRates are average annual per 100,000 age-adjusted to the 2000 U.S. standard population for the following States: California, Hawaii, Illinois, New Jersey, New York, Texas, and Washington
bRates for Native Hawaiians are calculated using the one or more race/ethnicities population denominators for Hawaii only (See Materials and methods)
Abbreviations: Lung = lung and bronchus; Liver = liver and intrahepatic bile duct; Non-Hodgkin = non-Hodgkin lymphoma
Discussion
Possible disparities in cancer incidence and mortality were identified for some of the API populations studied, using non-Hispanic whites as the referent. Liver cancer incidence and death rates were notably high among Chinese, Kampuchean, Korean, Laotian, Samoan, and Vietnamese men; and the rates for all API groups and both sexes in our study exceeded those for non-Hispanic white men and women. Infection with hepatitis B and C viruses is the major cause of liver cancer and individuals migrating from Asian, Middle Eastern, and African countries, where the viruses are endemic have been widely reported to be at increased risk for this cancer [28]. Stomach cancer incidence and death rates were higher for many of the API groups in our study when compared to rates for non-Hispanic whites. Asian Indian/Pakistani, and Filipinos were the exceptions, with their rates being closer to those for non-Hispanic whites. Studies of migrant populations suggest that exposure early in life to Helicobacter pylori plays a role in stomach cancer risk, in addition to possible dietary factors [29]. A majority of the API cancer patients in our study were born outside of the U.S., with the exception of Japanese-Americans and Native Hawaiians (data not shown). Birthplace information was missing from registry records, however, for about 28% of the API in this study. Incidence and death rates for nasopharyngeal cancer among Chinese, Filipino, and Vietnamese groups in our study are several times the magnitude of rates seen in other U.S. racial/ethnic groups [30]. Rates may also be high in other U.S. API groups, but the number of cases in our study is too small to provide precise estimates. Chinese and several Southeast populations—including Filipinos, Thais, and Vietnamese—have previously been reported at increased risk for this cancer [31] and rates are known to remain high among Chinese immigrants to the U.S. and other countries [32]. Consumption of preserved foods beginning at an early age is frequent among these groups and has been associated with this cancer [31].
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The low rates of lung, colorectal, and stomach cancers we observed among Asian Indians, either living in India or residing in other countries, have also been reported by others [33‐35]. Factors such as lower tobacco use and components of the South Asian diet have been suggested as playing important roles in these patterns [36‐38]. Breast cancer was a leading cancer among API women in our study, as it is in other racial/ethnic groups [39], but the breast cancer incidence rate in each API group, with the exception of native Hawaiians, was lower than that for non-Hispanic white women.
Though based on small numbers, we note that Samoan women had a smaller percentage of breast cancers diagnosed at an early stage and their breast cancer death rate was among the highest of the API groups. Others have reported low screening rates among Samoan women and note the need for targeted efforts to improve doctor–patient communication on prevention behavior [40, 41]. Samoan men had lower percentages of colorectal and prostate cancers diagnosed at an early stage and this may be reflected in their higher mortality rates for these cancers. Increased efforts to improve screening for these cancers in specific API groups may be needed. These results are based on small numbers of deaths among Samoans, however, and need to be confirmed in other studies. Furthermore, our findings must be interpreted cautiously, since the geographic coverage of the API study populations included in the incidence and mortality analyses are somewhat different.
Limitations of the source data must be recognized when analyzing racial/ethnic patterns of disease. Evaluations of the accuracy of cancer registry data on race/ethnicity, which is extracted from patient medical records, have shown varying levels of misclassification [42‐47]. A recent comparison of self-reported race/ethnicity obtained from interview studies with that from registry records was conducted by the Greater Bay Area Cancer Registry (comprising the San Francisco/Oakland and San Jose/Monterey regions of California) [42]. They found that sensitivities and positive predictive values (PV+) were high for non-Hispanic Whites and Blacks and were moderately high for Chinese (sensitivity = 77%, PV+ = 92%) leading to a 16% underestimate of Chinese cases. For Japanese and Filipinos, they reported comparable results of about 80% for both sensitivity and PV+; while for Vietnamese they reported low sensitivity (47%) and moderate PV+ (75%), yielding a 37% underestimate for this group. There were too few Koreans, South Asians (mostly Asian Indians), Laotians, Kampucheans, and Pacific Islanders to provide reliable estimates of sensitivity or PV+ in their study. In addition, about 7% of the diagnosed cancer cases in our incidence analysis were classified as Asian NOS or Pacific Islander NOS, thereby depressing the rates we reported for specific Asian or Pacific Islander groups. To address this problem, collaborative efforts are underway between the SEER Program registries and the National Association of Central Cancer Registries to improve how central registries classify cancer patients into specific Asian or Pacific Islander groups by using name lists and information on birthplace. Similar misclassification problems have been identified for death certificate information on race/ethnicity and have been reported to result in an 11% underestimate of mortality rates for the API group as a whole [48]. The impact of nonspecific API race on the mortality rates in our study is small, however, since less than 0.1% of deaths were coded as “API, NOS.” These limitations suggest that the API rates we have reported are generally biased downward, in spite of the fact that we used the single race population denominators in our rate calculations.
In conclusion, we found some evidence for cancer health disparities between specific API populations and non-Hispanic whites. The addition of population denominators for detailed API groups to SEER*Stat software developed by the National Cancer Institute’s Surveillance Research Program will enable public health researchers to utilize SEER databases to further investigate cancer incidence and mortality rates among these groups in the US [8]. Additional studies might include analyses that incorporate tumor characteristics (e.g., cancer subsite, histology, and grade) or other sociodemographic factors when examining racial/ethnic differences in cancer patterns.
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Open Access
This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
Open AccessThis is an open access article distributed under the terms of the Creative Commons Attribution Noncommercial License (https://creativecommons.org/licenses/by-nc/2.0), which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
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Appendix 1 Age-adjusted incidence ratesa for major cancersb by race/ethnicity and sex, 1998–2002
Count
Rate based on single race/ethnicity alone denominator
Rate based on one or more race/ethnicities denominator
Rate
95% CI
Rate
95% CI
LL
UL
LL
UL
Asian Indian & Pakistani/Men
All Sites
2,314
292.1
277.3
307.9
255.5
242.5
269.1
Prostate
701
98.4
90.0
107.7
86.1
78.8
94.2
Lung and bronchus
207
30.8
25.7
36.8
26.9
22.5
32.1
Colon and rectum
199
23.1
19.3
27.9
20.3
17.0
24.4
Lymphoma—Non-Hodgkin
142
15.8
12.5
20.1
13.8
11.0
17.5
Urinary bladder
98
15.8
12.1
20.5
13.8
10.6
17.8
Leukemia
138
12.2
9.5
15.9
10.7
8.3
13.9
Oral cavity (excl nasopharynx)
102
11.4
8.7
15.1
10.0
7.6
13.2
Liver and intrahepatic bile duct
60
8.7
6.2
12.3
7.6
5.4
10.7
Kidney and renal pelvis
64
8.4
6.0
11.7
7.3
5.3
10.2
Stomach
61
8.2
5.8
11.6
7.1
5.1
10.1
Pancreas
52
8.0
5.4
11.7
7.0
4.8
10.2
Brain and other nervous system
84
6.7
5.0
9.3
5.9
4.4
8.1
Myeloma
43
4.8
3.3
7.3
4.2
2.9
6.4
Larynx
23
4.5
2.5
7.7
3.9
2.2
6.6
Esophagus
27
3.6
2.1
6.2
3.2
1.9
5.4
Thyroid
40
2.7
1.8
4.7
2.4
1.6
4.1
Testis
38
2.3
1.3
4.5
2.0
1.2
3.9
Lymphoma—Hodgkin
36
2.0
1.4
3.7
1.7
1.2
3.2
Asian Indian & Pakistani/Women
All sites
2,229
238.1
226.7
250.2
208.2
198.4
218.6
Breast
864
82.1
76.1
88.8
72.3
67.0
78.1
Colon and rectum
147
18.8
15.5
23.0
16.4
13.5
19.9
Corpus and uterus, NOS
127
13.5
10.9
16.7
11.8
9.6
14.6
Lung and bronchus
90
13.1
10.2
16.9
11.3
8.9
14.5
Ovary
123
12.0
9.7
15.1
10.6
8.6
13.2
Lymphoma—Non-Hodgkin
92
9.4
7.3
12.3
8.2
6.4
10.7
Leukemia
86
9.0
6.8
12.0
7.8
5.9
10.4
Thyroid
111
8.3
6.6
10.7
7.3
5.9
9.4
Cervix Uteri
59
6.1
4.5
8.4
5.4
4.0
7.4
Brain and other nervous system
56
5.6
4.0
8.1
4.9
3.5
7.0
Esophagus
35
5.2
3.4
8.0
4.5
3.0
6.8
Oral cavity (excl nasopharynx)
41
5.0
3.3
7.6
4.3
2.9
6.5
Stomach
31
4.7
3.0
7.2
4.1
2.6
6.2
Pancreas
31
4.4
2.8
6.8
3.8
2.4
5.9
Myeloma
31
4.3
2.7
6.9
3.7
2.3
5.9
Liver and intrahepatic bile duct
31
3.9
2.6
6.2
3.4
2.2
5.4
Gallbladder
25
3.5
2.1
5.9
3.1
1.9
5.1
Urinary bladder
23
3.0
1.8
5.1
2.6
1.6
4.4
Kidney and renal pelvis
26
2.8
1.8
4.7
2.5
1.6
4.1
Lymphoma—Hodgkin
23
1.8
1.0
3.6
1.6
0.8
3.1
Chinese/Men
All sites
9,175
348.8
341.5
356.2
318.9
312.2
325.7
Prostate
2,209
84.8
81.2
88.5
78.2
74.9
81.7
Colon and rectum
1,400
54.0
51.2
57.0
49.6
46.9
52.3
Lung and bronchus
1,340
53.0
50.1
56.0
48.9
46.2
51.7
Liver and intrahepatic bile duct
666
24.0
22.1
25.9
21.7
20.1
23.5
Stomach
461
18.3
16.6
20.2
16.8
15.3
18.5
Urinary bladder
389
15.7
14.1
17.4
14.5
13.1
16.1
Lymphoma—Non-Hodgkin
401
14.8
13.4
16.4
13.5
12.1
14.9
Pancreas
243
9.8
8.5
11.1
9.0
7.9
10.3
Nasopharynx
277
8.9
7.9
10.1
7.9
7.0
8.9
Leukemia
231
8.7
7.6
10.0
7.6
6.6
8.7
Kidney and renal pelvis
192
7.2
6.2
8.4
6.6
5.7
7.7
Oral cavity (excl nasopharynx)
166
6.2
5.3
7.3
5.7
4.8
6.6
Esophagus
124
4.5
3.7
5.4
4.1
3.4
5.0
Brain and other nervous system
123
4.3
3.5
5.1
3.7
3.0
4.4
Thyroid
96
3.2
2.5
3.9
2.8
2.2
3.5
Larynx
78
3.0
2.3
3.8
2.7
2.2
3.5
Myeloma
74
2.7
2.1
3.5
2.5
2.0
3.2
Testis
57
1.7
1.3
2.2
1.4
1.1
1.9
Lymphoma—Hodgkin
40
1.3
0.9
1.8
1.1
0.8
1.6
Melanoma of the skin
35
1.2
0.8
1.7
1.1
0.8
1.6
Gallbladder
24
0.9
0.6
1.4
0.9
0.6
1.3
Chinese/Women
All Sites
8,817
270.4
264.7
276.2
243.5
238.4
248.7
Breast
2,652
77.6
74.6
80.6
69.3
66.6
72.0
Colon and rectum
1,257
40.2
38.0
42.5
36.7
34.7
38.8
Lung and bronchus
923
29.7
27.8
31.7
27.2
25.5
29.0
Corpus and uterus, NOS
406
12.0
10.9
13.3
10.8
9.8
11.9
Stomach
344
11.1
10.0
12.4
10.2
9.1
11.3
Thyroid
358
10.0
9.0
11.2
8.8
7.9
9.7
Ovary
335
10.0
8.9
11.1
8.8
7.9
9.9
Lymphoma—Non-Hodgkin
316
10.0
8.9
11.1
9.0
8.0
10.0
Liver and intrahepatic bile duct
258
8.2
7.3
9.3
7.5
6.6
8.5
Pancreas
209
6.8
5.9
7.8
6.3
5.4
7.2
Leukemia
188
5.9
5.1
6.9
5.1
4.4
6.0
Cervix Uteri
193
5.6
4.9
6.5
5.0
4.3
5.8
Urinary bladder
133
4.4
3.7
5.3
4.1
3.4
4.8
Kidney and renal pelvis
126
4.0
3.3
4.8
3.6
3.0
4.3
Oral cavity (excl nasopharynx)
119
3.6
3.0
4.4
3.3
2.7
3.9
Nasopharynx
125
3.5
2.9
4.2
3.1
2.6
3.7
Brain and other nervous system
90
2.7
2.2
3.4
2.3
1.9
2.9
Myeloma
76
2.5
2.0
3.1
2.3
1.8
2.9
Gallbladder
41
1.3
1.0
1.8
1.2
0.9
1.7
Esophagus
32
1.0
0.7
1.5
0.9
0.6
1.3
Melanoma of the skin
32
1.0
0.7
1.4
0.9
0.6
1.2
Lymphoma—Hodgkin
22
0.7
0.4
1.0
0.6
0.4
0.9
Filipino/Men
All Sites
9,206
393.2
385.1
401.5
357.3
349.8
364.9
Prostate
2,768
121.9
117.3
126.6
111.6
107.4
115.9
Lung and bronchus
1,665
72.5
69.0
76.1
66.2
63.0
69.6
Colon and rectum
1,194
50.4
47.5
53.4
45.9
43.2
48.6
Lymphoma—Non-Hodgkin
467
19.4
17.7
21.4
17.5
15.9
19.3
Liver and intrahepatic bile duct
413
17.2
15.5
19.0
15.6
14.1
17.2
Urinary bladder
267
12.4
10.9
14.0
11.4
10.0
12.9
Leukemia
249
10.0
8.8
11.4
8.7
7.6
10.0
Stomach
216
9.4
8.1
10.8
8.6
7.4
9.8
Pancreas
206
9.2
8.0
10.6
8.4
7.3
9.7
Kidney and renal pelvis
232
9.2
8.0
10.5
8.3
7.3
9.5
Thyroid
163
6.1
5.1
7.1
5.4
4.6
6.3
Myeloma
131
5.8
4.9
6.9
5.3
4.4
6.4
Oral cavity (excl nasopharynx)
138
5.8
4.8
6.9
5.2
4.4
6.2
Nasopharynx
129
4.8
4.0
5.7
4.3
3.5
5.1
Brain and other nervous system
100
3.8
3.1
4.7
3.2
2.6
4.0
Larynx
65
2.9
2.2
3.7
2.6
2.0
3.4
Esophagus
65
2.7
2.1
3.5
2.5
1.9
3.2
Testis
56
1.8
1.3
2.4
1.5
1.1
2.0
Lymphoma—Hodgkin
43
1.5
1.1
2.1
1.3
1.0
1.9
Melanoma of the skin
27
1.2
0.8
1.8
1.1
0.7
1.6
Gallbladder
22
1.0
0.6
1.6
0.9
0.6
1.5
Breast
18
0.9
0.5
1.4
0.8
0.5
1.3
Kaposi Sarcoma
24
0.8
0.5
1.3
0.7
0.5
1.1
Filipina/Women
All Sites
9,847
291.1
285.3
297.1
264.3
259.0
269.8
Breast
3,610
100.4
97.1
103.8
91.1
88.1
94.2
Colon and rectum
935
29.4
27.5
31.4
27.0
25.2
28.9
Lung and bronchus
802
26.0
24.1
27.9
23.9
22.3
25.8
Corpus and uterus, NOS
667
18.6
17.2
20.1
16.9
15.6
18.3
Thyroid
652
17.7
16.4
19.2
15.7
14.5
17.0
Lymphoma—Non-Hodgkin
379
12.2
11.0
13.6
11.2
10.0
12.4
Ovary
369
10.5
9.5
11.7
9.5
8.5
10.6
Cervix Uteri
361
10.0
9.0
11.2
9.0
8.1
10.1
Pancreas
233
7.7
6.7
8.9
7.1
6.2
8.2
Leukemia
183
5.8
4.9
6.7
5.0
4.2
5.8
Stomach
162
5.6
4.7
6.6
5.1
4.4
6.1
Liver and intrahepatic bile duct
150
5.1
4.3
6.0
4.7
3.9
5.6
Kidney and renal pelvis
162
4.8
4.1
5.7
4.4
3.7
5.1
Myeloma
126
4.2
3.5
5.0
3.9
3.2
4.7
Oral cavity (excl nasopharynx)
127
4.0
3.3
4.8
3.6
3.0
4.4
Brain and other nervous system
77
2.4
1.9
3.1
2.1
1.6
2.6
Urinary bladder
68
2.4
1.8
3.1
2.2
1.7
2.9
Lymphoma—Hodgkin
55
1.6
1.2
2.1
1.3
1.0
1.8
Nasopharynx
55
1.6
1.2
2.1
1.4
1.0
1.9
Gallbladder
43
1.4
1.0
2.0
1.3
0.9
1.8
Esophagus
34
1.1
0.8
1.6
1.0
0.7
1.5
Melanoma of the skin
27
0.8
0.5
1.2
0.7
0.5
1.1
Guamanian/Men
All Sites
79
252.1
189.8
336.7
197.8
148.8
264.7
Prostate
32
131.5
85.0
202.4
102.6
66.3
158.6
Guamanian/Women
All Sites
77
175.6
132.7
233.8
136.7
103.9
180.3
Breast
25
45.0
28.3
78.1
35.8
22.4
60.5
Lung and bronchus
16
40.7
22.4
76.4
33.0
18.2
60.1
NativeHawaiian (HIonly)/Menc
All Sites
1,664
–
–
–
531.6
503.7
561.1
Prostate
328
–
–
–
119.7
106.1
135.1
Lung and bronchus
329
–
–
–
109.8
97.4
123.9
Colon and rectum
198
–
–
–
65.7
56.1
77.1
Urinary bladder
55
–
–
–
21.2
15.3
29.1
Lymphoma—Non-Hodgkin
68
–
–
–
19.6
14.8
26.3
Stomach
62
–
–
–
18.8
14.1
25.3
Leukemia
58
–
–
–
16.3
11.8
22.7
Liver and intrahepatic bile duct
54
–
–
–
16.3
11.8
22.6
Kidney and renal pelvis
54
_
_
_
15.5
11.4
21.4
Pancreas
48
_
_
_
15.1
10.8
21.4
Oral cavity (excl nasopharynx)
53
_
_
_
13.7
10.1
19.2
Esophagus
33
_
_
_
9.6
6.4
14.7
Myeloma
26
_
_
_
8.6
5.3
14.0
Larynx
22
_
_
_
6.9
4.2
11.7
Brain and other nervous system
29
_
_
_
6.0
3.8
10.2
Testis
29
_
_
_
5.3
3.5
9.0
Thyroid
23
_
_
_
5.1
3.1
9.1
NativeHawaiian (HIonly)/Womenc
All Sites
1,979
_
_
_
488.5
466.5
511.3
Breast
736
_
_
_
175.8
163.0
189.4
Lung and bronchus
258
_
_
_
69.7
61.2
79.1
Colon and rectum
166
_
_
_
44.0
37.3
51.6
Corpus and uterus, NOS
162
_
_
_
37.5
31.9
44.1
Pancreas
68
_
_
_
18.6
14.3
23.9
Stomach
51
_
_
_
14.5
10.7
19.4
Thyroid
61
_
_
_
12.6
9.5
16.5
Cervix Uteri
56
_
_
_
12.3
9.2
16.4
Ovary
50
_
_
_
12.1
8.9
16.3
Lymphoma—Non-Hodgkin
47
_
_
_
11.7
8.5
16.0
Leukemia
45
_
_
_
9.4
6.7
13.1
Liver and intrahepatic bile duct
27
_
_
_
7.7
5.0
11.5
Urinary bladder
24
_
_
_
6.8
4.3
10.4
Myeloma
24
_
_
_
6.8
4.3
10.4
Oral cavity (excl nasopharynx)
25
_
_
_
5.8
3.7
8.9
Kidney and renal pelvis
22
–
_
_
5.4
3.4
8.5
Brain and other nervous system
25
–
_
_
5.0
3.2
7.9
Japanese/Men
All Sites
7,765
422.4
412.8
432.3
389.4
380.7
398.3
Prostate
2,211
115.0
110.1
120.1
108.9
104.3
113.6
Colon and rectum
1,402
75.9
71.9
80.2
70.7
67.0
74.6
Lung and bronchus
952
49.8
46.6
53.3
47.0
44.0
50.1
Stomach
542
29.3
26.9
32.1
27.6
25.3
30.1
Urinary bladder
438
22.9
20.8
25.4
21.6
19.6
23.8
Lymphoma—Non-Hodgkin
323
18.3
16.3
20.6
16.4
14.7
18.4
Pancreas
231
12.5
10.9
14.4
11.8
10.3
13.5
Kidney and renal pelvis
210
11.5
10.0
13.4
10.6
9.2
12.1
Liver and intrahepatic bile duct
199
11.4
9.8
13.3
10.3
8.9
11.9
Leukemia
173
11.4
9.6
13.5
8.8
7.5
10.2
Oral cavity (excl nasopharynx)
155
8.5
7.2
10.2
7.9
6.7
9.3
Esophagus
131
7.5
6.2
9.1
6.9
5.8
8.2
Testis
63
4.6
3.5
6.0
3.3
2.6
4.3
Brain and other nervous system
59
4.3
3.2
5.8
3.0
2.3
4.0
Thyroid
53
3.3
2.4
4.5
2.8
2.1
3.7
Larynx
57
3.1
2.4
4.2
2.9
2.2
3.8
Myeloma
52
2.8
2.1
3.8
2.6
1.9
3.4
Melanoma of the skin
35
2.1
1.5
3.2
1.8
1.3
2.6
Lymphoma—Hodgkin
17
1.5
0.8
2.5
0.9
0.5
1.5
Japanese/Women
All Sites
8,306
342.2
334.5
350.2
310.4
303.5
317.3
Breast
2,890
126.5
121.7
131.5
113.7
109.5
118.1
Colon and rectum
1,373
51.9
49.1
55.0
48.5
45.9
51.2
Lung and bronchus
691
24.7
22.8
26.8
23.4
21.6
25.3
Corpus and uterus, NOS
454
20.4
18.5
22.6
18.3
16.6
20.1
Stomach
414
15.0
13.6
16.8
14.2
12.8
15.7
Lymphoma—Non-Hodgkin
313
12.2
10.8
13.9
11.2
9.9
12.5
Pancreas
309
11.3
10.0
12.9
10.7
9.5
12.0
Ovary
242
11.1
9.6
12.8
9.7
8.5
11.1
Thyroid
156
8.2
6.9
9.8
6.8
5.7
8.0
Liver and intrahepatic bile duct
219
7.9
6.9
9.3
7.4
6.4
8.5
Leukemia
147
7.0
5.8
8.6
5.8
4.9
6.9
Cervix Uteri
118
6.2
5.1
7.6
5.2
4.3
6.3
Kidney and renal pelvis
122
4.8
4.0
6.0
4.4
3.6
5.3
Urinary bladder
130
4.7
3.9
5.8
4.4
3.7
5.3
Oral cavity (excl nasopharynx)
99
4.2
3.4
5.4
3.8
3.1
4.7
Brain and other nervous system
44
2.8
1.9
4.1
1.9
1.4
2.6
Myeloma
56
2.2
1.6
3.1
2.0
1.5
2.7
Melanoma of the skin
43
2.0
1.5
3.0
1.8
1.3
2.5
Esophagus
34
1.3
0.9
2.1
1.2
0.8
1.7
Gallbladder
23
0.9
0.6
1.6
0.8
0.5
1.3
Kampuchean/Men
All Sites
319
372.0
325.3
425.5
316.0
276.4
361.5
Lung and bronchus
56
82.6
60.1
112.6
69.3
50.6
94.7
Liver and intrahepatic bile duct
59
49.1
36.3
68.5
41.6
30.9
58.2
Prostate
27
39.7
25.0
62.2
33.6
21.3
52.8
Colon and rectum
30
30.0
18.3
49.5
25.8
15.7
42.7
Stomach
16
23.8
12.1
44.3
20.6
10.4
38.5
Lymphoma—Non-Hodgkin
23
22.1
12.8
39.2
18.6
10.8
33.1
Kampuchean/Women
All Sites
278
212.3
185.9
242.4
180.7
158.2
206.3
Breast
58
38.2
28.3
51.8
32.5
24.1
44.1
Lung and bronchus
26
24.6
15.6
37.8
21.0
13.3
32.4
Colon and rectum
25
21.1
13.1
33.2
17.9
11.2
28.3
Cervix Uteri
22
15.3
9.3
25.3
13.0
7.9
21.5
Liver and intrahepatic bile duct
16
14.1
7.6
24.9
12.0
6.5
21.3
Thyroid
20
13.4
7.8
23.2
11.4
6.6
19.7
Korean/Men
All Sites
2,832
372.6
357.4
388.4
356.2
341.6
371.3
Lung and bronchus
414
61.1
54.8
68.2
58.6
52.5
65.4
Colon and rectum
437
55.9
50.2
62.2
53.5
48.1
59.6
Prostate
383
55.7
49.8
62.3
53.5
47.8
59.8
Stomach
384
50.0
44.6
56.2
47.9
42.7
53.8
Liver and intrahepatic bile duct
319
35.9
31.6
40.8
34.3
30.2
39.0
Urinary bladder
106
14.6
11.7
18.3
14.0
11.2
17.6
Lymphoma—Non-Hodgkin
112
14.5
11.7
18.1
13.8
11.1
17.2
Pancreas
88
12.5
9.7
16.0
12.0
9.3
15.4
Kidney and renal pelvis
70
9.4
7.1
12.4
8.9
6.7
11.7
Oral cavity (excl nasopharynx)
69
8.6
6.5
11.4
8.2
6.2
10.9
Leukemia
67
8.1
6.1
10.9
7.5
5.6
10.1
Esophagus
35
5.2
3.4
7.7
4.9
3.3
7.4
Gallbladder
22
4.3
2.5
7.0
4.1
2.4
6.7
Thyroid
39
3.7
2.6
5.6
3.5
2.4
5.3
Larynx
26
3.2
2.0
5.2
3.1
2.0
5.0
Brain and other nervous system
32
2.9
2.0
4.6
2.7
1.8
4.3
Myeloma
17
2.1
1.1
4.0
2.0
1.1
3.8
Nasopharynx
16
1.7
0.8
3.3
1.6
0.8
3.2
Korean/Women
All Sites
3,135
254.5
245.2
264.1
243.5
234.6
252.7
Breast
779
53.5
49.7
57.6
51.0
47.4
54.9
Colon and rectum
408
35.9
32.3
39.8
34.5
31.1
38.3
Lung and bronchus
300
27.5
24.3
31.0
26.5
23.5
29.9
Stomach
294
26.3
23.3
29.7
25.3
22.4
28.6
Liver and intrahepatic bile duct
164
14.4
12.2
17.0
13.9
11.8
16.4
Cervix Uteri
142
10.8
9.0
12.8
10.3
8.6
12.3
Thyroid
145
9.8
8.2
11.7
9.2
7.8
11.0
Pancreas
87
8.4
6.6
10.5
8.1
6.4
10.1
Corpus and uterus, NOS
115
8.0
6.6
9.8
7.7
6.3
9.3
Ovary
102
7.5
6.1
9.3
7.2
5.8
8.9
Lymphoma—Non-Hodgkin
82
7.4
5.8
9.3
7.1
5.6
9.0
Urinary bladder
47
4.9
3.6
6.7
4.8
3.4
6.4
Leukemia
61
4.6
3.5
6.1
4.2
3.2
5.6
Kidney and renal pelvis
49
4.2
3.1
5.7
4.0
2.9
5.4
Gallbladder
36
3.4
2.4
4.9
3.3
2.3
4.7
Oral cavity (excl nasopharynx)
35
2.8
1.9
4.0
2.6
1.8
3.8
Brain and other nervous system
30
2.4
1.6
3.5
2.1
1.4
3.2
Myeloma
20
2.0
1.2
3.2
1.9
1.2
3.1
Laotian/Men
All Sites
376
407.2
360.7
460.3
357.2
316.0
404.4
Lung and bronchus
64
87.3
64.9
117.4
76.6
56.8
103.6
Liver and intrahepatic bile duct
80
79.4
60.7
105.0
69.8
53.2
92.8
Stomach
22
33.1
19.1
55.8
29.6
16.9
50.3
Prostate
21
30.9
18.2
51.9
27.0
15.9
45.9
Colon and rectum
30
30.2
19.4
48.8
26.2
16.9
42.8
Pancreas
21
21.6
12.5
38.7
18.8
10.9
34.1
Lymphoma—Non-Hodgkin
26
20.3
11.6
37.0
17.9
10.1
33.3
Laotian/Women
All Sites
299
297.9
263.0
337.1
260.5
229.9
294.7
Lung and bronchus
40
44.4
31.2
62.3
38.8
27.3
54.4
Breast
45
36.9
26.5
51.5
32.3
23.2
45.0
Colon and rectum
24
27.5
17.1
42.7
24.0
15.0
37.3
Cervix Uteri
28
24.8
16.0
38.0
21.7
14.0
33.3
Liver and intrahepatic bile duct
24
23.1
14.5
36.4
20.3
12.7
31.9
Samoan/Men
All Sites
356
566.7
498.8
645.5
471.2
415.1
535.6
Prostate
77
144.1
110.0
190.4
120.6
92.2
158.0
Lung and bronchus
70
111.9
84.4
151.1
94.1
71.0
126.0
Liver and intrahepatic bile duct
35
54.5
35.2
86.9
45.1
29.4
70.3
Stomach
30
53.0
33.2
86.1
44.7
28.0
71.3
Colon and rectum
31
43.1
26.6
72.8
35.8
22.0
59.3
Leukemia
19
23.0
10.9
49.7
18.8
8.6
39.8
Samoan/Women
All Sites
396
472.0
421.5
528.6
394.5
352.2
441.9
Breast
94
102.5
81.7
129.5
86.2
68.6
108.9
Corpus and uterus, NOS
67
66.1
50.3
88.2
55.2
41.8
73.7
Lung and bronchus
41
56.9
39.6
81.3
48.1
33.4
68.6
Colon and rectum
28
38.6
24.1
60.5
32.2
20.2
50.3
Cervix Uteri
19
18.1
10.6
32.7
15.1
8.8
27.3
Tongan/Men
All Sites
95
428.8
329.9
555.9
367.4
283.6
473.6
Lung and bronchus
18
107.0
55.2
193.0
87.9
46.3
156.2
Prostate
16
85.0
44.5
157.4
74.7
39.3
135.5
Tongan/Women
All Sites
139
504.7
414.1
616.6
430.5
352.8
526.5
Breast
35
118.0
78.1
181.2
100.8
66.7
154.9
Corpus and uterus, NOS
26
91.2
56.4
150.1
77.8
48.0
128.3
Vietnamese/Men
All Sites
3,020
374.3
358.5
390.9
351.7
336.9
367.2
Lung and bronchus
543
72.3
65.3
80.2
68.0
61.4
75.3
Prostate
415
59.1
52.8
66.3
55.6
49.6
62.3
Liver and intrahepatic bile duct
493
55.5
49.9
62.0
52.4
47.1
58.4
Colon and rectum
338
41.2
36.1
47.1
38.8
34.0
44.3
Stomach
178
25.6
21.2
30.9
24.0
19.9
28.9
Lymphoma—Non-Hodgkin
143
14.7
11.9
18.5
13.8
11.1
17.3
Urinary bladder
86
13.6
10.4
17.8
12.7
9.7
16.6
Pancreas
86
11.4
8.7
15.0
10.7
8.2
14.1
Leukemia
84
9.9
7.5
13.2
9.2
7.0
12.3
Oral cavity (excl nasopharynx)
69
7.7
5.6
10.7
7.2
5.3
10.0
Nasopharynx
75
6.7
5.1
9.1
6.3
4.8
8.6
Esophagus
43
6.5
4.4
9.7
6.1
4.1
9.1
Kidney and renal pelvis
44
5.0
3.5
7.5
4.7
3.3
7.1
Brain and other nervous system
52
4.9
3.4
7.4
4.6
3.2
6.9
Larynx
29
4.3
2.6
7.0
4.0
2.5
6.6
Thyroid
48
4.0
2.8
6.2
3.8
2.7
5.8
Myeloma
23
2.7
1.6
4.7
2.5
1.5
4.5
Testis
19
1.2
0.7
2.8
1.1
0.7
2.6
Vietnamese/Women
All Sites
2,720
270.6
259.6
282.2
254.9
244.5
265.8
Breast
647
52.8
48.6
57.5
49.9
45.9
54.3
Lung and bronchus
290
34.4
30.3
39.1
32.5
28.5
36.9
Colon and rectum
302
33.3
29.3
37.8
31.4
27.6
35.6
Cervix Uteri
189
16.8
14.3
19.8
15.9
13.6
18.7
Liver and intrahepatic bile duct
146
16.8
14.0
20.1
15.8
13.2
18.9
Stomach
110
13.8
11.1
17.0
13.0
10.5
16.0
Thyroid
174
13.3
11.2
15.8
12.5
10.6
14.8
Lymphoma—Non-Hodgkin
116
12.0
9.7
14.8
11.3
9.1
13.9
Pancreas
81
10.0
7.8
12.7
9.4
7.3
12.0
Ovary
100
8.6
6.9
10.8
8.1
6.5
10.2
Corpus and uterus, NOS
95
8.2
6.5
10.4
7.8
6.2
9.8
Leukemia
70
6.6
4.9
8.7
6.1
4.6
8.1
Oral cavity (excl nasopharynx)
46
5.0
3.5
7.0
4.7
3.3
6.6
Myeloma
34
4.3
2.9
6.2
4.0
2.7
5.9
Urinary bladder
24
3.6
2.3
5.6
3.4
2.1
5.2
Brain and other nervous system
31
2.7
1.7
4.1
2.5
1.6
3.8
Nasopharynx
27
2.3
1.5
3.7
2.2
1.4
3.5
Gallbladder
19
2.2
1.3
3.7
2.1
1.2
3.5
Kidney and renal pelvis
16
1.7
0.9
3.1
1.6
0.9
2.9
Non − HispanicWhite/Mend
All Sites
649,731
587.0
585.6
588.5
Prostate
189,678
170.0
169.3
170.8
Lung and bronchus
98,625
89.2
88.7
89.8
Colon and rectum
71,656
65.6
65.2
66.1
Urinary bladder
46,682
43.0
42.6
43.4
Melanoma of the skin
32,981
29.3
29.0
29.6
Lymphoma—Non-Hodgkin
27,294
24.6
24.3
24.9
Kidney and renal pelvis
19,671
17.5
17.2
17.7
Leukemia
18,718
17.3
17.1
17.6
Oral cavity (excl nasopharynx)
18,462
16.2
16.0
16.5
Pancreas
14,220
13.0
12.8
13.2
Stomach
10,797
9.9
9.7
10.1
Brain and other nervous system
9,893
8.9
8.7
9.1
Esophagus
9,079
8.1
8.0
8.3
Larynx
8,101
7.1
7.0
7.3
Testis
7,816
7.0
6.9
7.2
Liver and intrahepatic bile duct
7,445
6.7
6.5
6.8
Myeloma
7,264
6.6
6.4
6.8
Thyroid
4,996
4.3
4.2
4.5
Lymphoma—Hodgkin
3,833
3.5
3.4
3.6
Kaposi Sarcoma
1,247
1.1
1.1
1.2
Gallbladder
768
0.7
0.7
0.8
Nasopharynx
717
0.6
0.6
0.7
Non − HispanicWhite/Womend
All Sites
617,158
448.5
447.3
449.6
Breast
195,231
145.2
144.5
145.8
Lung and bronchus
83,387
59.0
58.6
59.4
Colon and rectum
70,298
47.6
47.2
47.9
Corpus and uterus, NOS
35,224
26.0
25.7
26.2
Melanoma of the skin
24,455
19.3
19.0
19.5
Lymphoma—Non-Hodgkin
24,177
17.2
17.0
17.5
Ovary
20,736
15.3
15.1
15.5
Thyroid
14,103
11.8
11.6
12.0
Urinary bladder
15,480
10.6
10.4
10.8
Leukemia
13,800
10.0
9.8
10.1
Pancreas
14,520
9.8
9.6
9.9
Kidney and renal pelvis
11,787
8.5
8.4
8.7
Cervix Uteri
9,930
8.1
7.9
8.3
Oral cavity (excl nasopharynx)
8,996
6.5
6.3
6.6
Brain and other nervous system
7,911
6.2
6.1
6.4
Stomach
6,430
4.3
4.2
4.4
Myeloma
5,986
4.1
4.0
4.2
Lymphoma—Hodgkin
3,348
2.9
2.8
3.0
Liver and intrahepatic bile duct
3,689
2.6
2.5
2.6
Esophagus
3,067
2.1
2.0
2.2
Larynx
2,255
1.7
1.6
1.7
Gallbladder
1,754
1.2
1.1
1.2
Nasopharynx
315
0.2
0.2
0.3
Kaposi Sarcoma
169
0.1
0.1
0.1
aRates are average annual per 100,000 age-adjusted to the 2000 U.S. standard population for the following SEER areas: Atlanta, Detroit, Seattle/Puget Sound, CA (Los Angeles, Greater Bay Region, remainder of State), CT, HI, IA, KY, LA, NJ, NM, UT
bCancers are sorted in descending order of the rate within each race/ethnic and sex group
cRates for Native Hawaiians are calculated using only the one or more race/ethnicities population denominator (See Materials and methods)
dRates for Non-Hispanic Whites are calculated using the bridged single-race population denominator (See Materials and methods)
Appendix 2 Age-adjusted mortality ratesa for major cancersb by race/ethnicity and sex, 1998–2002
Count
Rate based on single race/ethnicity alone denominator
Rate based on one or more race/ethnicities denominator
Rateb
95% CI
Rateb
95% CI
LL
UL
LL
UL
Asian Indian/Male
All Sites
852
82.8
75.7
90.5
72.1
66.0
78.8
Lung and bronchus
160
17.2
14.1
21.1
15.0
12.3
18.4
Prostate
62
10.6
7.8
14.2
9.1
6.7
12.2
Pancreas
53
5.8
4.1
8.3
5.1
3.6
7.2
Liver and intrahepatic bile duct
54
5.3
3.6
7.7
4.6
3.1
6.7
Leukemia
73
4.8
3.3
7.1
4.2
2.9
6.1
Colon and rectum
48
4.1
2.6
6.3
3.6
2.3
5.4
Stomach
44
3.7
2.5
5.7
3.3
2.2
5.0
Urinary bladder
21
3.7
2.1
6.1
3.2
1.8
5.3
Lymphoma—Non-Hodgkin
40
3.7
2.4
5.7
3.2
2.1
5.0
Esophagus
33
3.5
2.2
5.7
3.1
1.9
4.9
Brain and other nervous system
55
3.3
2.3
5.1
2.9
2.0
4.4
Oral cavity (excl nasopharynx)
36
2.9
1.7
4.8
2.5
1.5
4.2
Myeloma
27
2.2
1.4
3.8
1.9
1.2
3.3
Asian Indian/Female
All Sites
821
67.4
62.2
73.1
58.7
54.2
63.6
Breast
178
11.2
9.4
13.5
9.9
8.3
11.8
Lung and bronchus
70
6.4
4.8
8.5
5.6
4.2
7.4
Colon and rectum
55
5.3
3.8
7.3
4.6
3.3
6.3
Ovary
66
5.0
3.7
6.8
4.3
3.2
5.9
Pancreas
37
3.5
2.4
5.2
3.1
2.1
4.5
Leukemia
48
3.5
2.4
5.1
3.0
2.1
4.4
Esophagus
28
2.8
1.7
4.4
2.4
1.5
3.7
Lymphoma—Non-Hodgkin
29
2.6
1.7
4.1
2.3
1.4
3.5
Liver and intrahepatic bile duct
29
2.6
1.7
4.0
2.3
1.5
3.5
Stomach
24
2.4
1.4
4.0
2.1
1.2
3.4
Brain and other nervous system
29
2.4
1.5
3.8
2.1
1.3
3.3
Cervix Uteri
28
2.2
1.4
3.6
1.9
1.2
3.1
Myeloma
25
2.1
1.3
3.4
1.8
1.1
2.9
Corpus and uterus, NOS
22
1.6
1.0
2.7
1.4
0.8
2.4
Gallbladder
20
1.5
0.9
2.6
1.3
0.8
2.3
Chinese/Male
All Sites
5,807
167.8
163.4
172.4
156.2
152.0
160.4
Lung and bronchus
1,603
47.0
44.7
49.5
43.9
41.7
46.2
Liver and intrahepatic bile duct
761
20.3
18.8
21.9
18.8
17.4
20.2
Colon and rectum
657
19.5
18.0
21.2
18.2
16.8
19.7
Stomach
404
11.7
10.5
12.9
10.9
9.8
12.1
Prostate
292
10.4
9.2
11.7
9.8
8.7
11.0
Pancreas
291
8.5
7.5
9.6
7.9
7.0
9.0
Leukemia
216
6.1
5.3
7.1
5.7
4.9
6.5
Lymphoma—Non-Hodgkin
205
6.0
5.2
6.9
5.6
4.8
6.4
Nasopharynx
192
4.5
3.9
5.2
4.1
3.5
4.7
Esophagus
134
3.8
3.1
4.5
3.5
2.9
4.2
Urinary bladder
109
3.6
3.0
4.4
3.4
2.8
4.2
Kidney and renal pelvis
102
2.9
2.3
3.5
2.7
2.2
3.3
Brain and other nervous system
94
2.5
2.0
3.1
2.3
1.8
2.8
Oral cavity (excl nasopharynx)
65
1.8
1.4
2.4
1.7
1.3
2.2
Myeloma
58
1.7
1.3
2.2
1.6
1.2
2.1
Larynx
33
0.9
0.6
1.3
0.9
0.6
1.2
Gallbladder
24
0.7
0.5
1.1
0.7
0.4
1.0
Melanoma of the skin
21
0.6
0.3
0.9
0.5
0.3
0.8
Chinese/Female
All Sites
4,537
107.7
104.5
110.9
99.6
96.6
102.5
Lung and bronchus
984
23.8
22.4
25.4
22.1
20.8
23.6
Colon and rectum
524
12.8
11.7
13.9
11.9
10.9
12.9
Breast
564
12.3
11.3
13.4
11.3
10.4
12.3
Liver and intrahepatic bile duct
308
7.4
6.5
8.2
6.8
6.1
7.6
Stomach
305
7.3
6.5
8.2
6.8
6.1
7.6
Pancreas
273
6.7
6.0
7.6
6.3
5.6
7.1
Ovary
229
5.2
4.6
6.0
4.8
4.2
5.5
Lymphoma—Non-Hodgkin
172
4.1
3.5
4.8
3.8
3.2
4.4
Leukemia
132
3.1
2.6
3.7
2.8
2.4
3.4
Cervix Uteri
93
2.2
1.8
2.7
2.0
1.6
2.5
Corpus and uterus, NOS
89
2.1
1.6
2.5
1.9
1.5
2.3
Brain and other nervous system
81
1.8
1.4
2.3
1.6
1.3
2.0
Kidney and renal pelvis
63
1.6
1.2
2.0
1.5
1.1
1.9
Nasopharynx
65
1.4
1.1
1.8
1.3
1.0
1.7
Myeloma
49
1.2
0.9
1.6
1.2
0.9
1.5
Esophagus
45
1.1
0.8
1.5
1.0
0.7
1.4
Urinary bladder
38
1.0
0.7
1.4
0.9
0.7
1.3
Oral cavity (excl nasopharynx)
34
0.8
0.6
1.1
0.8
0.5
1.1
Gallbladder
28
0.7
0.5
1.0
0.7
0.4
1.0
Thyroid
20
0.5
0.3
0.8
0.5
0.3
0.8
Filipino/Male
All Sites
3,890
155.6
150.6
160.8
142.3
137.7
147.0
Lung and bronchus
1,200
47.9
45.1
50.8
43.8
41.3
46.5
Prostate
377
17.8
16.1
19.8
16.6
14.9
18.3
Colon and rectum
411
16.1
14.6
17.8
14.8
13.3
16.3
Liver and intrahepatic bile duct
304
11.3
10.1
12.7
10.3
9.1
11.6
Lymphoma—Non-Hodgkin
226
9.1
7.9
10.4
8.3
7.2
9.5
Pancreas
171
7.0
6.0
8.2
6.5
5.5
7.5
Leukemia
155
5.7
4.8
6.7
5.1
4.3
6.0
Stomach
123
4.9
4.1
5.9
4.5
3.7
5.4
Myeloma
77
3.2
2.5
4.0
2.9
2.3
3.7
Kidney and renal pelvis
80
3.0
2.3
3.7
2.7
2.1
3.4
Brain and other nervous system
74
2.7
2.1
3.4
2.4
1.9
3.1
Esophagus
66
2.6
2.0
3.3
2.4
1.8
3.0
Urinary bladder
43
2.0
1.4
2.7
1.9
1.3
2.5
Oral cavity (excl nasopharynx)
46
1.8
1.3
2.5
1.7
1.2
2.3
Nasopharynx
45
1.5
1.1
2.1
1.4
1.0
1.9
Larynx
20
0.8
0.5
1.3
0.8
0.5
1.2
Thyroid
21
0.8
0.5
1.3
0.8
0.5
1.2
Gallbladder
18
0.7
0.4
1.2
0.7
0.4
1.1
Filipino/Female
All Sites
3,429
96.1
92.8
99.5
88.4
85.3
91.5
Breast
693
17.2
15.9
18.6
15.7
14.5
17.0
Lung and bronchus
592
17.2
15.8
18.7
15.9
14.6
17.3
Colon and rectum
314
9.0
8.0
10.1
8.3
7.3
9.3
Pancreas
207
6.3
5.4
7.2
5.8
5.0
6.7
Ovary
212
5.6
4.9
6.5
5.2
4.5
6.0
Lymphoma—Non-Hodgkin
143
4.4
3.7
5.3
4.1
3.4
4.9
Liver and intrahepatic bile duct
127
3.9
3.3
4.7
3.7
3.0
4.4
Stomach
101
3.2
2.6
3.9
2.9
2.4
3.6
Leukemia
112
3.1
2.5
3.8
2.8
2.3
3.4
Cervix Uteri
113
2.8
2.3
3.5
2.6
2.1
3.2
Corpus and uterus, NOS
106
2.8
2.3
3.4
2.5
2.1
3.1
Myeloma
80
2.4
1.9
3.0
2.2
1.8
2.8
Kidney and renal pelvis
52
1.4
1.1
1.9
1.3
1.0
1.8
Brain and other nervous system
50
1.4
1.0
1.9
1.2
0.9
1.7
Thyroid
41
1.2
0.8
1.6
1.1
0.8
1.5
Urinary bladder
20
0.7
0.4
1.1
0.6
0.4
1.0
Oral cavity (excl nasopharynx)
22
0.7
0.4
1.0
0.6
0.4
1.0
Gallbladder
21
0.7
0.4
1.0
0.6
0.4
1.0
Esophagus
21
0.6
0.4
1.0
0.6
0.3
0.9
Nasopharynx
17
0.5
0.3
0.8
0.4
0.2
0.7
Guamanian/Male
All Sites
60
147.0
106.5
201.8
111.8
81.6
152.4
Lung and bronchus
23
47.4
28.4
81.0
37.4
22.7
62.8
Guamanian/Female
All Sites
48
98.5
69.5
138.8
73.4
52.4
101.9
Native Hawaiian/Malec
All Sites
790
_
_
_
263.7
243.7
285.4
Lung and bronchus
257
_
_
_
87.7
76.4
100.7
Colon and rectum
81
_
_
_
26.9
20.8
34.9
Prostate
48
_
_
_
21.9
15.7
30.1
Stomach
44
_
_
_
14.1
9.9
20.2
Liver and intrahepatic bile duct
38
_
_
_
11.8
7.9
17.7
Pancreas
38
_
_
_
11.4
7.8
16.9
Leukemia
29
_
_
_
9.0
5.6
14.3
Esophagus
27
_
_
_
8.4
5.4
13.4
Lymphoma—Non-Hodgkin
26
_
_
_
8.0
4.9
13.2
Myeloma
18
_
_
_
5.2
3.0
9.5
Brain and other nervous system
16
_
_
_
3.9
2.1
7.8
Native Hawaiian/Femalec
All Sites
738
_
_
_
198.9
184.4
214.4
Lung and bronchus
173
_
_
_
47.6
40.6
55.6
Breast
132
_
_
_
33.5
27.9
40.1
Pancreas
61
_
_
_
16.8
12.7
21.8
Colon and rectum
48
_
_
_
13.1
9.5
17.7
Stomach
36
_
_
_
10.3
7.1
14.6
Ovary
30
_
_
_
8.4
5.6
12.3
Corpus and uterus, NOS
26
_
_
_
6.7
4.3
10.2
Lymphoma—Non-Hodgkin
24
_
_
_
6.6
4.2
10.2
Liver and intrahepatic bile duct
22
_
_
_
6.4
3.9
10.0
Myeloma
18
_
_
_
5.2
3.1
8.5
Cervix Uteri
21
_
_
_
5.2
3.2
8.3
Leukemia
18
_
_
_
4.6
2.7
7.7
Japanese/Male
All Sites
3,327
173.7
167.7
179.9
162.7
157.1
168.4
Lung and bronchus
777
39.5
36.7
42.5
37.3
34.7
40.0
Colon and rectum
497
25.8
23.6
28.3
24.2
22.1
26.5
Stomach
315
16.6
14.8
18.7
15.6
13.9
17.5
Prostate
284
15.2
13.5
17.3
14.6
12.9
16.5
Pancreas
234
12.2
10.6
14.0
11.5
10.0
13.1
Liver and intrahepatic bile duct
170
9.1
7.8
10.8
8.5
7.2
9.9
Esophagus
142
7.8
6.6
9.3
7.2
6.1
8.5
Lymphoma—Non-Hodgkin
146
7.5
6.3
8.9
7.0
5.9
8.3
Leukemia
111
5.9
4.9
7.3
5.4
4.4
6.5
Kidney and renal pelvis
89
4.7
3.8
5.9
4.3
3.5
5.4
Urinary bladder
88
4.6
3.6
5.8
4.3
3.5
5.4
Brain and other nervous system
45
2.6
1.9
3.7
2.2
1.6
2.9
Oral cavity (excl nasopharynx)
37
1.9
1.4
2.9
1.8
1.3
2.5
Myeloma
30
1.4
1.0
2.2
1.4
0.9
2.0
Japanese/Female
All Sites
3,276
117.0
112.9
121.4
109.2
105.4
113.2
Lung and bronchus
585
19.7
18.1
21.5
18.6
17.1
20.3
Colon and rectum
421
15.3
13.8
17.0
14.4
13.0
15.9
Breast
385
15.1
13.6
16.9
13.9
12.5
15.4
Pancreas
314
10.6
9.4
12.1
10.1
9.0
11.3
Stomach
289
10.2
9.0
11.6
9.6
8.5
10.8
Liver and intrahepatic bile duct
196
6.5
5.6
7.7
6.1
5.2
7.0
Ovary
134
5.1
4.2
6.2
4.7
3.9
5.6
Lymphoma—Non-Hodgkin
143
5.0
4.2
6.1
4.7
4.0
5.6
Leukemia
104
4.0
3.2
5.1
3.6
3.0
4.4
Corpus and uterus, NOS
83
3.1
2.5
4.1
2.9
2.3
3.6
Cervix Uteri
40
1.7
1.2
2.5
1.5
1.1
2.1
Myeloma
47
1.6
1.2
2.3
1.5
1.1
2.0
Urinary bladder
42
1.4
1.0
2.2
1.4
1.0
1.9
Kidney and renal pelvis
37
1.3
0.9
2.1
1.2
0.9
1.8
Brain and other nervous system
28
1.2
0.8
2.0
1.0
0.7
1.5
Esophagus
33
1.1
0.8
1.8
1.1
0.7
1.6
Oral cavity (excl nasopharynx)
25
0.9
0.6
1.6
0.9
0.6
1.3
Gallbladder
23
0.8
0.5
1.4
0.7
0.5
1.1
Korean/Male
All Sites
1,762
196.5
186.2
207.4
188.6
178.6
199.0
Lung and bronchus
415
50.6
45.3
56.5
48.6
43.6
54.3
Stomach
302
31.5
27.5
36.0
30.2
26.4
34.6
Liver and intrahepatic bile duct
288
26.3
23.0
30.2
25.2
22.0
28.9
Colon and rectum
151
17.6
14.6
21.3
16.9
14.0
20.5
Pancreas
105
11.4
9.1
14.3
11.0
8.8
13.8
Prostate
43
6.8
4.7
9.5
6.5
4.6
9.2
Lymphoma—Non-Hodgkin
53
6.2
4.4
8.5
5.9
4.2
8.2
Leukemia
58
5.5
4.0
7.5
5.2
3.8
7.2
Urinary bladder
30
4.1
2.6
6.2
3.9
2.5
6.0
Esophagus
34
3.7
2.4
5.7
3.6
2.3
5.5
Gallbladder
20
3.1
1.8
5.2
3.0
1.7
5.0
Kidney and renal pelvis
28
3.0
1.9
4.7
2.9
1.9
4.5
Brain and other nervous system
27
2.0
1.3
3.4
1.9
1.2
3.3
Korean/Female
All Sites
1,561
108.2
102.6
114.1
104.2
98.8
109.9
Lung and bronchus
276
20.7
18.2
23.4
20.0
17.6
22.6
Stomach
211
14.5
12.5
16.8
14.0
12.1
16.2
Colon and rectum
171
12.1
10.3
14.2
11.7
9.9
13.7
Liver and intrahepatic bile duct
169
11.7
9.9
13.7
11.3
9.6
13.2
Breast
144
7.8
6.5
9.3
7.5
6.3
8.9
Pancreas
97
7.5
6.1
9.3
7.3
5.9
9.0
Ovary
71
4.5
3.5
5.8
4.3
3.3
5.6
Cervix Uteri
53
3.1
2.3
4.2
3.0
2.2
4.0
Lymphoma—Non-Hodgkin
39
2.9
2.1
4.1
2.8
2.0
4.0
Leukemia
43
2.6
1.8
3.6
2.5
1.7
3.5
Gallbladder
27
2.2
1.4
3.3
2.1
1.4
3.2
Corpus and uterus, NOS
26
1.7
1.1
2.6
1.6
1.0
2.5
Kidney and renal pelvis
20
1.7
1.0
2.6
1.6
1.0
2.5
Brain and other nervous system
23
1.5
0.9
2.3
1.4
0.9
2.2
Myeloma
18
1.4
0.8
2.3
1.4
0.8
2.2
Samoan/Male
All Sites
193
293.9
247.6
348.6
240.0
202.5
284.1
Lung and bronchus
54
74.0
53.6
102.9
61.2
44.4
84.6
Stomach
22
40.9
24.1
67.6
33.6
19.9
55.0
Prostate
14
36.2
18.9
64.4
29.2
15.3
51.5
Liver and intrahepatic bile duct
22
32.9
19.3
56.1
26.8
15.8
44.9
Colon and rectum
19
31.6
17.2
56.0
25.2
13.9
44.1
Samoan/Female
All Sites
172
209.3
176.5
248.2
170.7
144.0
202.1
Lung and bronchus
29
42.0
27.1
63.7
34.1
22.2
51.4
Breast
32
36.2
24.0
54.9
29.7
19.7
44.7
Vietnamese/Male
All Sites
1,398
159.9
149.9
170.7
150.6
141.1
160.7
Lung and bronchus
368
43.9
38.7
49.9
41.4
36.5
46.9
Liver and intrahepatic bile duct
335
33.8
29.6
38.8
31.9
27.9
36.6
Stomach
95
12.7
9.8
16.4
11.9
9.2
15.4
Pancreas
76
8.9
6.6
11.9
8.4
6.3
11.2
Colon and rectum
84
8.8
6.6
11.7
8.3
6.3
11.0
Leukemia
58
7.2
5.1
10.1
6.7
4.8
9.4
Prostate
30
6.7
4.3
10.0
6.2
4.0
9.4
Lymphoma—Non-Hodgkin
53
5.2
3.6
7.5
4.9
3.4
7.1
Oral cavity (excl nasopharynx)
30
3.6
2.2
5.9
3.4
2.0
5.5
Brain and other nervous system
31
2.9
1.7
4.9
2.7
1.6
4.6
Kidney and renal pelvis
18
2.6
1.3
4.8
2.4
1.3
4.5
Esophagus
19
2.6
1.4
4.7
2.4
1.3
4.4
Urinary bladder
18
2.0
1.1
3.8
1.9
1.1
3.6
Nasopharynx
22
1.7
1.0
3.3
1.6
0.9
3.1
Vietnamese/Female
All Sites
992
97.8
91.2
104.9
92.0
85.8
98.6
Lung and bronchus
181
20.2
17.1
23.7
19.0
16.1
22.3
Liver and intrahepatic bile duct
102
10.9
8.8
13.6
10.3
8.2
12.8
Breast
102
7.6
6.1
9.5
7.2
5.7
9.0
Colon and rectum
73
7.4
5.6
9.7
7.0
5.3
9.1
Stomach
72
7.0
5.3
9.2
6.6
5.0
8.7
Pancreas
62
6.2
4.7
8.3
5.9
4.4
7.8
Ovary
54
4.5
3.3
6.2
4.3
3.1
5.9
Cervix Uteri
52
4.4
3.2
6.1
4.2
3.0
5.8
Leukemia
51
4.2
3.0
5.8
3.9
2.8
5.4
Lymphoma–Non-Hodgkin
34
4.0
2.7
5.9
3.8
2.6
5.5
Myeloma
13
1.6
0.8
3.0
1.5
0.8
2.8
Brain and other nervous system
17
1.5
0.8
2.6
1.4
0.8
2.4
Corpus and uterus, NOS
17
1.4
0.8
2.6
1.4
0.8
2.4
Non − HispanicWhite/Mend
All Sites
349,031
241.3
240.5
242.1
Lung and bronchus
106,623
72.2
71.8
72.7
Prostate
37,137
27.7
27.4
28.0
Colon and rectum
35,261
24.6
24.3
24.8
Pancreas
18,399
12.6
12.4
12.8
Lymphoma—Non-Hodgkin
15,368
10.6
10.5
10.8
Leukemia
15,119
10.6
10.4
10.8
Urinary bladder
11,682
8.4
8.2
8.6
Esophagus
11,536
7.7
7.6
7.9
Brain and other nervous system
9,477
6.3
6.2
6.4
Kidney and renal pelvis
9,135
6.2
6.1
6.3
Liver and intrahepatic bile duct
9,091
6.1
6.0
6.3
Stomach
8,395
5.8
5.7
5.9
Melanoma of the skin
6,998
4.7
4.6
4.8
Myeloma
6,454
4.5
4.4
4.6
Oral cavity a(excluding Nasopharynx)
5,605
3.7
3.6
3.8
Larynx
3,316
2.2
2.2
2.3
Lymphoma—Hodgkin
936
0.6
0.6
0.7
Gallbladder
683
0.5
0.4
0.5
Thyroid
673
0.5
0.4
0.5
Breast
504
0.3
0.3
0.4
Testis
475
0.3
0.3
0.4
Nasopharynx
383
0.3
0.2
0.3
Non − HispanicWhite/Womend
All Sites
341,117
171.7
171.1
172.2
Lung and bronchus
87,084
44.5
44.2
44.8
Breast
53,534
27.8
27.5
28.0
Colon and rectum
36,430
17.3
17.1
17.5
Ovary
18,962
9.8
9.6
9.9
Pancreas
19,471
9.5
9.4
9.6
Lymphoma—Non-Hodgkin
14,024
6.8
6.7
7.0
Leukemia
12,132
6.0
5.9
6.1
Corpus and uterus, NOS
8,368
4.2
4.1
4.3
Brain and other nervous system
7,602
4.2
4.1
4.3
Myeloma
5,948
2.9
2.8
3.0
Stomach
5,930
2.8
2.8
2.9
Kidney and renal pelvis
5,611
2.8
2.7
2.9
Liver and intrahepatic bile duct
5,546
2.7
2.7
2.8
Urinary bladder
5,228
2.4
2.3
2.5
Cervix Uteri
4,206
2.4
2.3
2.5
Melanoma of the skin
4,075
2.2
2.1
2.2
Corpus Uteri
3,822
1.9
1.9
2.0
Esophagus
3,766
1.8
1.8
1.9
Oral cavity a(excluding Nasopharynx)
3,142
1.6
1.5
1.6
Gallbladder
1,675
0.8
0.8
0.9
Larynx
992
0.5
0.5
0.6
Lymphoma—Hodgkin
800
0.5
0.4
0.5
Thyroid
917
0.5
0.4
0.5
Nasopharynx
245
0.1
0.1
0.1
aRates are average annual per 100,000 age-adjusted to the 2000 U.S. standard population for the following States: CA, HI, IL, NJ, NY, TX, and WA
bCancers are sorted in descending order of the rate within each race/ethnic and sex group
cRates for Native Hawaiians are calculated using only the one or more race/ethnicities population denominator (See Materials and methods)
dRates for Non-Hispanic Whites are calculated using the bridged single-race population denominator (See Materials and methods)
