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Editor's Correspondence
March 10, 2003

Cancer Survival in US Racial/Ethnic Groups: Heterogeneity Among Asian Ethnic Subgroups

Arch Intern Med. 2003;163(5):631. doi:10.1001/archinte.163.5.631

The recent article by Clegg et al1 presents valuable information regarding survival following cancers of the prostate, breast, lung, and colon/rectum among the major racial/ethnic groups in the United States based on data from the Surveillance, Epidemiology, and End Results (SEER) program. Such population-based survival statistics can provide a basis for additional research into the sociodemographic or clinical factors that might contribute to racial/ethnic disparities in cancer outcomes. In the analysis of Clegg et al, survival data for Chinese, Japanese, and Filipino populations are combined and presented as one "Asian American" category. However, the US Asian population includes a heterogeneous mix of persons from the Far East, Southeast Asia, and the Indian subcontinent and encompasses Chinese, Japanese, Filipinos, Koreans, Asian Indians, and numerous Southeast Asian groups such as Vietnamese, Cambodians, Laotians, and Hmong.2 US Asians are also heterogeneous in terms of their immigration history; 1990 Census data show that, while 80% of Japanese Americans were born in the United States, only 20% of Vietnamese Americans were US-born.3,4 The diversity in culture, language, migration patterns, dietary and other lifestyle practices, and preferences among persons categorized as Asian translates into very different health behaviors and disease risks.5 Thus, the common practice of aggregating data for Asians may obscure informative variations in patterns of health or disease occurrence among subgroups.

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