VIEW, Calif. ó When Margaret Abe-Koga was diagnosed with
breast cancer in 2015, she was as surprised as anyone.
all, no one ever had breast cancer in her Japanese-American
family, she doesnít have the genetic marker, and sheíd
been led to believe that Asian-Americans werenít ó as
Abe-Koga put it ó "a high-propensity group" for
proved otherwise for the three-term Mountain View city
councilwoman, as it has for a growing number of
Asian-Americans in California confronting a sobering trend:
While breast cancer rates have plateaued or declined in some
racial groups, they have been steadily rising among
Asian-Americans since 1988.
findings, released last week by the Fremont-based Cancer
Prevention Institute of California, show the largest increase
in breast cancer rates in the Golden State is occurring among
Koreans and Southeast Asians. Japanese-Americans showed the
slowest increases, but suffered the highest breast cancer
rates among seven Asian-American groups in the study.
results stunned Abe-Koga, 46, who in January went through
breast reconstruction surgery after undergoing a double
mastectomy, chemotherapy and radiation. For generations, she
said, Asian-Americans have been under the wrong impression
that breast cancer "is not prevalent in our
community" so "itís not something that people
started to think maybe there is that aspect within our
community: Our folks are more silent about what they are going
through and donít necessarily share, or they arenít
getting the testing they should get," she said.
confusion among Asian-American women is understandable. As of
2013, the U.S. Centers for Disease Control and Prevention
reported that white women had the highest rate of breast
cancer, followed by black, Hispanic, Asian/Pacific Islander
and American Indian/Alaska Native women.
CDCís numbers are nationwide. By comparison, the new study
is based on the California Cancer Registry in a state that has
the largest population of Asian-Americans in the country. With
a population of approximately 5.7 million in California,
Asian-Americans now make up about 15 percent of the stateís
Lin Gomez, the studyís lead author, said the results are
revealing because they are the first to evaluate patterns
among seven major Asian-American ethnic groups, by age and
stage of cancer.
showed breast cancer rates rose among Korean women in
California an astonishing 4.7 percent each year from 1988 to
2006, before slightly declining over the next seven years. The
rates climbed 2.5 percent a year between 1998-2013 among
Southeast Asians (Cambodians, Laotians, Hmong and Thai), and
1.4 percent among South Asians (Indians and Pakistanis).
no consensus on why breast cancer rates are on the rise among
Asian-Americans. But risk factors could include delaying
childbirth, changing diets, a rise in obesity and alcohol use.
Better screening could also be a reason behind the increase.
studies from the 1970s and 1980s showed increasing breast
cancer rates among Japanese-Americans, but they have leveled
off. Lin Gomez said that may be because Japanese have been in
the U.S. longer than the other Asian ethnic groups whose
numbers are growing.
know that breast cancer risk increases with acculturation ó
that is, adoption of Western lifestyles," Lin Gomez said.
And that is consistent with the fact that the most rapidly
increasing breast cancer rates are seen among the more
recently immigrated groups such as Koreans, South Asians, and
study hits close to home for Lin Gomez, who is
Chinese-American, and said aspects of the Asian culture could
be contributing to the growing numbers, including a tendency
to consider cancer a stigma ó and to keep quiet within a
Yoo, a professor of Asian-American Studies at San Francisco
State University who has written extensively on Asian-American
health issues, including breast cancer, is familiar with those
a perception among some Asian-Americans that breast cancer is
"a white womanís disease," Yoo said. "Itís
just not on their radar."
many Asian-Americans arrive in the U.S. with no family history
of the disease "so there isnít that intergenerational
communication" around the importance of breast cancer
screenings. Diagnosed at later stages, these women then face
greater mortality than their white counterparts, she said.
because many of these women equate the diagnosis as a death
sentence, she said, they may not aggressively pursue
study notes increasing trends of late-stage cancer among
Asian-Americans ó particularly among Filipino, Korean and
South Asian women, who are the least likely to get screened.
Sherry Cava and her three children arrived in the U.S. from
her native Philippines to join her mother in Daly City. About
a month later, she felt a lump in her breast. Cava, now 44,
had never had a mammogram or even routine annual checkups
after her three pregnancies, because of the prohibitive cost
of health care.
the Philippines, when you donít feel anything, you donít
go to the doctor," Cava said. "Itís only when youíre
experiencing constant pain that you go."
after she told a cousin, a nurse at San Francisco General
Hospital, about the lump, she was able to get a mammography,
ultrasound and biopsy done on the same day, Cava said.
Abe-Koga, her breast cancer treatment involved chemotherapy, a
mastectomy and radiation. But Cavaís family did have a
history of the disease: Her 70-year-old maternal grandmother
had been successfully treated for it.
who completed her last cancer treatments last summer, said she
believes if she had not come to America, her cancer would not
have been caught as early.
am blessed to be here at this moment," she said.