Based on the results of a population-based, descriptive, cross-sectional study published in JAMA Network Open by Gomez et al, invasive breast cancer incidence rates accelerated among Asian American, Native Hawaiian, and Pacific Islander women over 2 decades.
“The rapid recent increases in breast cancer incidence in [these ethnic groups], especially early-onset disease, warrant urgent attention,” the investigators commented.
Study Details
Using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program from 14 U.S. states representing the Northeast, Midwest, South, and West regions, the investigators examined invasive breast cancer incidence trends among 148,608 Asian American, Native Hawaiian, and Pacific Islander women diagnosed between January 1, 2000, and December 31, 2022. The study included seven Asian American (Asian Indian or Pakistani, Chinese, Filipino, Japanese, Korean, Laotian or Kampuchean, and Vietnamese) and two Native Hawaiian or Pacific Islander (Guamanian, Chamorro, and Samoan populations and Native Hawaiians) ethnic groups.
The cohort included 138,808 Asian American (93.4%) and 9,800 Native Hawaiian or Pacific Islander (6.6%) women. At diagnosis, 44,234 patients (29.8%) were younger than age 50 and 104,374 (70.2%) were aged 50 years and older. Most patients had localized-stage disease (63.9%), and 66.6% had hormone receptor–positive, ERBB2 (formerly HER2 or HER2/neu)-negative breast cancer.
The investigators evaluated incidence trends overall and by age group (< 50 years and ≥ 50 years), stage (localized, regional, and distant), and subtype (hormone receptor and ERBB2 status). Annual (or triannual) percentage changes (APCs) in incidence rates were estimated using joinpoint regression, with analyses conducted from September 2025 through March 2026.
Key Findings
From 2012 to 2022, Asian American women experienced a greater increase in invasive breast cancer incidence than other racial and ethnic groups, with an APC of 2.34% (95% confidence interval [CI] = 1.83%–3.68%). The investigators reported a smaller steady increase among Native Hawaiian or Pacific Islander women (APC = 0.84%, 95% CI = 0.48%–1.29%) from 2000 to 2022.
Overall and early-onset (< 50 years) invasive breast cancer incidence appeared to increase significantly across nearly all Asian American, Native Hawaiian, and Pacific Islander ethnic groups. The largest recent annual increases were observed among Chinese women (overall [2016–2022]: APC = 4.39%, 95% CI = 2.58%–7.70%; early-onset [2017–2022]: APC = 4.57%, 95% CI = 2.03%–8.36%) and Vietnamese women (overall [2015–2022]: APC = 4.12%, 95% CI = 2.32%–8.10%; early-onset [2016–2022]: APC = 4.30%, 95% CI = 1.98%–8.93%).
The most pronounced increases in incidence by stage were observed in distant-stage disease, with APCs from 2004 to 2022 of 4.02% (95% CI = 2.74%–5.72%) among Asian Indian and Pakistani women and 4.52% (95% CI = 2.55%–7.09%) among Chinese women.
Trends in hormone receptor–positive, ERBB2-negative breast cancer incidence were found to significantly increase among nearly all Asian American groups, with APCs since 2010 ranging from 2.10% (95% CI = 0.74%–3.45%) for Japanese women to 6.00% (95% CI = 3.62%–8.78%) for Korean women, whereas stable trends were reported for Native Hawaiian and Pacific Islander groups. Nearly all Asian American groups experienced increases in triple-negative breast cancer incidence, the investigators reported, with the largest increase observed among Chinese women (APC = 6.17%; 95% CI = 3.30%–11.73%) from 2017 to 2022.
“This population-based, descriptive, cross-sectional study covering a more than 20-year period found rapid recent increases in breast cancer incidence in Asian American, Native Hawaiian, and Pacific Islander women, especially for early-onset breast cancer,” the investigators concluded.
Looking ahead, they added, “Research tailored to these distinct ethnic groups is needed to discern potentially novel risk factors for breast cancer. Culturally sensitive efforts are needed to promote awareness and increase breast cancer screening in distinct ethnic groups.”
Scarlett Lin Gomez, PhD, MPH, of the University of California, San Francisco, is the corresponding author of the article in JAMA Network Open.
Disclosure: The study authors reported no conflicts of interest. For funding information, visit jamanetwork.com.
