Abstract A04: Childhood cancer incidence among specific Asian and Pacific Islander populations in the U.S.
Authors: Moore Kristin J. , Hubbard Aubrey K. , Williams Lindsay A. , Spector Logan G. 
Published: August 2020

Abstract
Background: We sought to explore variation in childhood cancer incidence rates among specific Asian and Pacific Islander (API) groups. Despite high genetic diversity in this region of the world, API groups in the United States are often combined into a single race/ethnic group.
Methods: The Surveillance, Epidemiology, and End Results (SEER) Detailed Asian/Pacific Islander (2000-Centered) data was used for this analysis. Cancer diagnoses occurring between January 1998 to December 2002 from 14 SEER registries were included. Detailed racial/ethnic population data from the 2000 census was used to calculate incidence rates for individual races with at least 500,000 individuals. We also combined this data into groups based on geographic regions and genetic similarity, which included East Asia (China, Japan, Korea; n=377 cases), Southeast Asia (Vietnam, Laos, Cambodia; n=136 cases), Asian Indian/Pakistan (n=163 cases), Oceania (Guam, Samoa, Tonga; n=29 cases), and the Philippines (n=199 cases). Incidence rate ratios (IRR) and 95% confidence intervals (CI) were calculated comparing each API regional group to non-Hispanic Whites (NHW), and each API regional group to East Asians.
Results: Incidence rates among detailed Asian and Pacific Islander groups varied. Acute lymphoblastic leukemia (ALL) was significantly lower in children of SE Asian (IRR 0.59, 95% CI 0.42, 0.82) and Filipino (IRR 0.73, 95% CI 0.57, 1.00) descent compared to non-Hispanic Whites. Acute myeloid leukemia (AML) was more common among children from Oceania compared to NHW (IRR 3.44, 95% CI 1.63, 7.28). Central nervous system (CNS) cancers were less common among East Asian (IRR 0.74, 95% CI 0.58, 0.96), SE Asian (IRR 0.45, 95% CI 0.28, 0.73), and Filipino (IRR 0.48, 95% CI 0.32, 0.72) children compared to NHW. When comparing the incidence of cancers among API regions, few clear patterns emerged. The incidence of AML in children from Oceania was nearly four times that in East Asians (IRR 3.88, 95% CI 1.64, 9,.11), though roughly the same among all other regions. The incidence rates of ALL (IRR 0.63, 95% CI 0.41, 0.97) and malignant gonadal germ cell tumors (IRR 0.29 95% CI 0.08, 0.97) were lower in SE Asians compared to East Asians. Lymphoma was twice as common in Asian Indians/Pakistani children compared to East Asians (IRR 2.13, 95% CI 1.33, 2.29).
Conclusions: The variation observed in cancer incidence patterns among these groups is important and may indicate differences in underlying etiology and/or exposure patterns. These findings highlight possible disparities in cancer incidence between specific API groups.
Citation Format: Kristin J. Moore, Aubrey K. Hubbard, Lindsay A. Williams, Logan G. Spector. Childhood cancer incidence among specific Asian and Pacific Islander populations in the U.S. [abstract]. In: Proceedings of the AACR Special Conference on the Advances in Pediatric Cancer Research; 2019 Sep 17-20; Montreal, QC, Canada. Philadelphia (PA): AACR; Cancer Res 2020;80(14 Suppl):Abstract nr A04.