The Surveillance, Epidemiology and End Results (SEER) Program
of the National Cancer Institute (NCI) has published a study reporting
on patterns of cancer in a variety of racial and ethnic groups
in the United States.
The SEER monograph, Racial/Ethnic Patterns of Cancer in the
United States, 1988-1992, includes average annual age-adjusted
cancer incidence rates for the Alaska Native, American Indian
(New Mexico), black, Chinese, Filipino, Hawaiian, Japanese, Korean,
Vietnamese, and white populations. The data are also presented
for Hispanic (total), white Hispanic, and white non-Hispanic populations.
Cancer mortality, compiled by the NCI using data from the National
Center for Health Statistics, is reported for each of these groups
except Korean and Vietnamese, for whom data are unavailable.
Also included are estimates of the number of newly diagnosed cancers
and cancer deaths in the United States, by cancer site, for each
racial/ethnic group in 1990. Selected data from the report are
Reaching Those Most In Need
"We are pleased to have this study completed, because it
helps us tailor our education, outreach, and intervention efforts
to reach populations most in need," said Brenda K. Edwards,
phd, director of NCI's Cancer Control Research Program. "We
also anticipate extensive use of these data by the health care
and research community."
Benjamin F. Hankey, scd, chief of NCI's Cancer Statistics Branch,
added, "The data provide a basis for monitoring cancer rates
in diverse populations, with unique cultures and lifestyles as
well as possibly unique genetic factors that may influence cancer
The SEER Program is a continuing project of NCI, responsible for
monitoring the impact of cancer in the general population. It
consists of a network of cancer registries that cover the states
of Connecticut, Hawaii, Iowa, New Mexico, and Utah; and the metropolitan
areas of Atlanta (including 10 rural counties), Detroit, Los Angeles,
San Francisco/Oakland, San Jose/Monterey (California), and Seattle/Puget
Sound. In addition, data were provided by the Alaska Area Native
Health Service for use in the monograph.
The SEER Program covers about 14% of the US population overall,
but by design includes substantially larger percentages of minority
populations: 78% of
Hawaiians, 60% of Japanese, 49% of Filipinos, 43% of Chinese,
34% of Koreans, 31% of Vietnamese, 27% of American Indians, and
25% of Hispanics. This is necessary to enable the calculation
of cancer rates for these smaller populations.
Broad Similarities on Some Measures of Cancer
The racial/ethnic groups were found to be broadly similar on some
measures of cancer. Men have higher overall cancer rates than
women in all groups. The ratio of male to female incidence rates
ranges from 1.1:1 in Alaska Natives to 1.7:1 in blacks. However,
in all groups, women 30 to 54 years old have higher rates than
men of the same age range, due to the high incidence of female
breast and gynecologic cancers.
Black men have the highest overall cancer incidence and mortality,
largely due to excesses of prostate and lung cancers. Among women,
cancer is most common in non-Hispanic whites, while the cancer
death rate is highest in Alaska Natives.
One chapter of the report cites the five most frequently diagnosed
cancers and the five most common causes of cancer death for each
racial/ethnic group. Breast cancer incidence ranks first in all
groups of women except Vietnamese, who have a higher rate of cervical
cancer. However, breast cancer incidence rates vary fourfold,
from 28.5 per 100,000 Korean women to 115.7 per 100,000 non-Hispanic
In terms of mortality, lung cancer ranks first in most groups
of women, and is in either first or second place in all groups
except American Indians. Breast cancer mortality ranks in the
top two sites for all groups of women except Alaska Natives, in
whom it ranks third.
Among men, either prostate or lung cancer ranks first in each
racial/ethnic group for both incidence and mortality. Prostate
cancer incidence varies more than sevenfold, from 24.2 per 100,000
Koreans to 180.6 per 100,000 blacks. Colorectal cancer incidence
rates also vary substantially: The Alaska Native rates are more
than four times as high as the American Indian rates for both
men and women.
A few generally rare cancers appear in the top five sites for
specific groups. Cancer of the gallbladder ranks fourth in American
Indian women in New Mexico, for instance, while thyroid cancer
is fourth in Filipino women. Nasopharyngeal cancer, which is common
in China and Southeast Asia, occurs much more frequently in Chinese
and Vietnamese American men than in blacks, whites, and other
groups, although it does not make the top five sites in any group.