Disaggregated Colorectal Cancer Mortality among Asian American Subgroups between 2005 and 2020

Colorectal cancer is the second leading cause of cancer death in Asian Americans. Asian Americans are a diverse, heterogeneous population composed of groups with differing cancer risk factors. Few prior studies have analyzed colorectal cancer mortality by disaggregated Asian racial subgroup.

Using 2005 to 2020 US national mortality records linked to American Community Survey one-year population estimates, we report age-standardized mortality rates per 100,000 person-years, standardized mortality ratios (SMR), and average annual percent change trends for the six largest Asian subgroups in a serial, cross-sectional study design. We compared these rates with non-Hispanic Whites. We stratified rates by sex, nativity, and colorectal cancer location (colon vs. rectum).

Asian subgroups demonstrated substantial heterogeneity in colorectal cancer mortality. Relative to the non-Hispanic White group, Asian Indian Americans had the lowest rate [female SMR = 0.3; 95% confidence interval (CI), 0.3-0.3 and male SMR = 0.3; 95% CI, 0.3-0.3] and Japanese Americans the highest rate (female SMR = 0.9; 95% CI, 0.8-0.9 and male SMR = 0.9; 95% CI, 0.9-1.0). Chinese, Filipino, Korean, and Vietnamese Americans demonstrated mortality between Asian Indian and Japanese. Over the study period, most Asian subgroups had stable or decreasing mortality. However, both Korean and Vietnamese colorectal cancer mortality increased over the period. By the end of the study period, Korean Americans had the highest colorectal cancer mortality of any Asian subgroup.

Asian subgroups demonstrate heterogeneity in patterns of colorectal cancer mortality, emphasizing the necessity of disaggregation in cancer research.

Our study provides disaggregated Asian subgroup colorectal cancer mortality data, which may allow for targeted risk attenuation efforts.