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Christina Kashiwada noticed a small itchy lump on her left breast while traveling for work in the summer of 2018.
At first she thought a little. She had regular check-ups and kept up with medical appointments. But a relative urged her to get a mammogram. She takes the advice and learns she has stage 3 breast cancer, a revelation that shocks her.
“I'm 36, right?” said Kashiwada, a civil engineer in Sacramento, California. “Nobody thinks about cancer.”
In 2021, approximately 11,000 Asian American and Pacific Islander women will be diagnosed with breast cancer, and approximately 1,500 will die. The latest federal data show that the rate of new breast cancer diagnoses among Asian American and Pacific Islander women — a group that once had relatively low rates of diagnosis — is growing much faster than many other racial and ethnic groups. The trend is particularly sharp among young women like Kashiwada.
In 2021, 55 out of every 100,000 Asian American and Pacific Islander women will be diagnosed with breast cancer, which is higher than the rate for black and Hispanic women and equal to the rate for white women. Age-adjusted data From the National Institutes of Health. (Hispanics may be of any race or combination of races, but are classified separately in this data.)
The rate of new breast cancer among Asian Americans and Pacific Islanders under 50 increased by 52 percent from 2000 to 2021. API women 50 to 64 grew by 33 percent. time. In comparison, the rate for women of all ages, races, and ethnicities increased by 3 percent.
Researchers have picked up on this trend and are scrambling to figure out why this ethnic disparity is occurring. They suspect the answer is complex, ranging from cultural changes to stressful lifestyles – but they recognize it's a mystery and difficult for patients and their families to discuss because of cultural differences.
Helen ChewDirector of the Clinical Breast Cancer Program at UC Davis Health, says the Asian American diaspora is like that. Wide and varied Simple explanations for the rise in breast cancer are unclear.
“It's a real trend, it's hard to tease out exactly why,” added Chew. Are we seeing an influx of people who have little ability to care? Is it because of a lot of culture that they don't want to go in if they see something on their chest?
There is an urgency to solve this mystery because it costs lives. While breast cancer death rates for women in most ethnic and racial groups are declining dramatically, about 12 out of 100,000 Asian American and Pacific Islander women of any age died from breast cancer in 2023, essentially the same death rate as in 2000, according to interim data from the Centers for Disease Control and Prevention. During that time, the breast cancer death rate for all women fell by 30 percent.
The CDC does not release breast cancer death rates for many different Asian American women, such as those of Chinese or Korean descent. However, it has begun to distinguish Asian American women and Pacific Islander women.
About 9,000 Asian American women died of breast cancer from 2018 to 2023, compared to about 500 for Native Hawaiians and Pacific Islanders. However, there were breast cancer death rates 116% higher Among Hawaiian and Pacific Islander Asian American women during that period.
Rates of Pancreas, Thyroid, ColonAnd endometrium Cancer, with Non-Hodgkin lymphoma The rate among Asian American and Pacific Islander women under 50 has increased significantly, according to NIH data. However, breast cancer is more common among young API women than other types of cancer – especially because they are young women More likely Face The more aggressive the disease, the higher the death rate.
We are seeing an increase of about 4 percent per year, he said Scarlett Gomezprofessor and epidemiologist at the Helen Diller Family Comprehensive Cancer Center at the University of California-San Francisco. “We're seeing more than a 4 percent increase in Asian/Pacific Islander women under 50.”
Gomez is the lead investigator at A. Great study Exploring the causes of cancer in Asian Americans. She said there is not enough research yet to determine the cause of the recent increase in breast cancer. The answer may involve multiple risk factors over time.
“One of the hypotheses we're investigating there is the role of stress,” she says. Throughout our lives we ask all kinds of questions about different sources of stress, different coping mechanisms.
It's probably just because there's more screening. “We've looked at the trends over time and we're seeing similar increases across all stages of the disease,” Gomez said.
Veronica the womanA professor and epidemiologist at the Keck School of Medicine at the University of Southern California, the trend may be related to Asian immigrants adopting certain lifestyles. The woman was diagnosed with breast cancer a few years ago at the age of 49.
“Asian women, American women, because they're becoming more Western, they're hitting puberty now — earlier. [the first menstrual cycle] is it. Associated with increased riskThe woman, who is working with Gomez on cancer research, said. “in case Giving birth laterWe delay childbearing We do not breastfeed. – All are associated with increased risk of breast cancer.
Moon ChenProfessor at the University of California-Davis and a Cancer Health Differences ExpertHe just added. A small fraction NIH funding is focused on cancer research among Asian Americans.
Whatever the reason, the trend has caused anxiety for many patients over the years.
Kashiwada underwent a mastectomy following her breast cancer diagnosis. During surgery, doctors at UC Davis Health discovered the cancer had spread to lymph nodes in her arm. She underwent eight rounds of chemotherapy and 20 radiation treatments.
Throughout her treatments, Kashiwada kept her ordeal a secret from her grandmother. Her grandmother never knew about the diagnosis. “I didn't want her to worry about me or worry about her,” Kashiwada said. “If she knew this was happening, she would never sleep. It was very important to me to protect her. ”
Kashiwada left with her parents. Her mother took time off work to help care for her.
Kashiwada's two younger children, who were 3 and 6 at the time, stayed with their father so she could focus on her recovery.
“The kids come after school,” she said. “My father used to bring them and bring them almost every day while their father was at work.”
Kashiwada spent months regaining strength after radiation treatments. She returned to work but on doctor's orders to avoid heavy lifting.
A few weeks before the start of the 2020 Covid lockdowns, Kashiwada underwent her final reconstructive surgery. But her treatment was not over.
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Her doctors told her that estrogen was feeding her cancer, so they gave her medication to help her end her periods early. The treatment was not as effective as they had hoped. The doctor She had surgery to remove her ovaries in 2021.
She was recently diagnosed with osteopenia and will start injections to stop bone loss.
Kashiwada has overcome most of the negative feelings she's felt about her illness and says she wants other young women like her to understand that they are at higher risk, including Asian American women.
“I would say that no matter how healthy you think you are, or how much you exercise, or whatever it is that you do, eating well, which is everything I do — it doesn't make you invincible or immune,” she said. . “Not to say you have to fear everything, but to be in tune with your body and what your body is telling you.”
Philip Reese is an expert in information reporting and an associate professor of journalism at California State University-Sacramento.
This article was prepared by KFF health newsto be published California Health Linean editorially independent service California Health Care Foundation Additional support comes from Association of Asian American Journalists – Los Angeles Through California Endowment.