Background:

Asian Americans (AAs) and Native Hawaiians and other Pacific Islanders (NHPIs) have suboptimal human papillomavirus (HPV) vaccination and cancer screening rates. AAs and NHPIs are often aggregated, masking disparities characterized by varying colonization/immigration patterns and cultural/religious beliefs between populations and ethnicities. We examined the incidence of HPV-associated cancers across disaggregated AA and NHPI ethnicities.

Methods:

Using the Surveillance, Epidemiology, and End Results “Detailed Asian/Pacific Islander” Database, we calculated 1990-2014 sex-specific age-standardized HPV-associated cancer incidence of cervical carcinoma, oropharyngeal squamous cell carcinoma (SCC), vulvar SCC, vaginal SCC, anal SCC, and penile SCC, by ethnicity: Asian Indian/Pakistani, Chinese, Filipino, Japanese, Kampuchean, Korean, Laotian, Native Hawaiian, other Pacific Islander, and Vietnamese. Trends by calendar period (1990-1996, 1997-2002, 2003-2008, 2009-2014) were estimated using Joinpoint regression.

Results:

The most common HPV-associated cancer was cervical carcinoma in women and oropharyngeal SCC in men. During 1990-2014, cervical carcinoma incidence per 100,000 ranged from 4.5 (Asian Indian/Pakistani) to 20.7 (Laotian). Cervical carcinoma incidence only statistically significantly declined for Asian Indian/Pakistani, Filipino, Korean, Laotian, and Vietnamese women (range=19.9%-44.1% decline per period). Among men, oropharyngeal SCC incidence per 100,000 ranged from 1.1 (Chinese) to 5.1 (Native Hawaiian). Oropharyngeal SCC incidence only statistically significantly increased for Japanese men (31.0% increase per period). Heterogeneity across ethnicities were observed for other cancer sites.

Conclusions:

HPV-associated cancer incidence varied widely between AAs and NHPIs and by ethnicity, underscoring the need for improved data capture of ethnic groups in research and more tailored interventions to better address health disparities between AA and NHPI populations.