Cancer: Cross-Roads of Ethnicity and Environment



This chapter provides a description of cancer in the Arab American community. It first presents estimates of the cancer incidence and mortality in the Arab world and identifies the top five cancers in Arab men as lung, bladder, prostate, Non-Hodgkin lymphoma, and liver and in Arab women as breast, colorectal, cervix, Non-Hodgkin lymphoma, and ovary. In contrast, the top five cancers in US men and women are, respectively, prostate, lung, colorectal, bladder and skin melanoma, and breast, lung, colorectal, uterus, and thyroid. Cancer incidence in Arab Americans has been estimated because unlike Hispanics and Asians, Arab ethnicity is not specifically identified in the US Census and other data sources, nor is nativity status routinely available. Based on these estimates, the incidence of liver and stomach cancers in Arab Americans are higher and lung cancer is lower than that of Non-Hispanic Whites in the United States. However, without knowledge of nativity status, the US estimates cannot determine what differences are due to migration to a new environment and which are genetic. Finally, the available information on cancer control and prevention among Arab Americans is summarized. In general, smoking patterns are unclear, obesity seems to be prevalent, especially among women, and cancer screening services are not fully utilized. Additional study is critically needed to improve our understanding of the cancer burden among Arab Americans.


Cancer immigration prevention 


  1. Adami, H., Day, N., Trichopoulos, D., & Willett, W. (2001). Primary and secondary prevention in the reduction of cancer morbidity and mortality. European Journal of Cancer, 37(Suppl 8), s118–127.PubMedCrossRefGoogle Scholar
  2. Adamo, M., Johnson, C., Ruhl, J., & DIckie, L. (2011). SEER Program Coding and Staging Manual 2011. Bethesda: Department of Health and Human Services.Google Scholar
  3. Al-Omari, H., & Scheibmeir, M. (2009). Arab Americans’ acculturation and tobacco smoking. Journal of Transcultural Nursing, 20(2), 227–223.PubMedCrossRefGoogle Scholar
  4. American Cancer Society. (2012). Cancer Facts and Figures 2012. Atlanta: American Cancer Society.Google Scholar
  5. Arfken, C., Arnetz, B., Fakhouri, M., Ventimiglia, M., & Jamil, H. (2011). Alcohol use among Arab Americans: What is the prevalence. Journal of Immigrant and Minority Health, 13(4), 713–718. doi: 10.1007/s10903-011-9447-8.PubMedCrossRefGoogle Scholar
  6. Aswad, M., & Hammad, A. (2001). Health Survey of the Arab, Muslim and Chaldean Communities in Michigan available at
  7. Australian Institute of Health and Welfare. (2000). Australia’s health 2000. Canberra: Australian Institute of Health and Welfare.Google Scholar
  8. Ayash, C., Axelrod, D., Nejmeh-Khoury, S., Aziz, A., Yusr, A., & Gany, F. M. (2011). A community intervention: AMBER: Arab American breast cancer education and referral program. Journal of Immigrant and Minority Health, 13(6), 1041–1047.PubMedCrossRefGoogle Scholar
  9. Barcenas, C., Wilkinson, A., Strom, S., Cao, Y., Saunders, K., Mahabir, S., et al. (2007). Birthplace, years of residence in the United States, and obesity among Mexican-American adults. Obesity (Silver Spring), 15(4), 1043–1052.CrossRefGoogle Scholar
  10. Baron-Epel, O., Haviv-Messika, A., Green, M., & Kalutzki, D. (2004). Ethnic differences in reported smoking behaviors in face-to-face and telephone interviews. European Journal of Epidemiology, 19, 679–686.PubMedCrossRefGoogle Scholar
  11. Centers for Disease Control and Prevention. (2012a). Cancer Screening—United States, 2010. Morbidity and Mortality Weekly Report, 61(3), 41–45.Google Scholar
  12. Centers for Disease Control and Prevention. (2012b). Prevalence and trends data. Retrieved July 2010, from Centers for Disease Control and Prevention
  13. Daw, M. A., & Dau, A. A. (2012). Hepatitis C virus in Arab world: a state of concern. Scientific World Journal, 2012:719494. doi: 10.1100/2012/719494. Epub 2012 May 2.Google Scholar
  14. de la Cruz, G. P., & Brittingham, A. (2003). The Arab population:2000. In U.S. Census Bureau (Ed.), Census 2000 Brief available at http//
  15. Dey, A., & Lucas, J. (2004). Physical and mental health characteristics of U.S.-born and foreign-born adults 1997–2002. Retrieved from
  16. El-Sayed, A. M., & Galea, S. (2009). The health of Arab-Americans living in the United States: A systematic review of the literature. BMC Public Health, 9, 272. doi: 10.1186/1471-2458/9/272.PubMedCrossRefGoogle Scholar
  17. Ennis, S., Rios-Vargas, M., & Albert, N. (2011). The Hispanic Population: 2010. In U.S. Census Bureau (Ed.), Census Brief 2010. available at
  18. Fennelly, K. (2005). The ‘healthy migrant’ effect. Minnesota Medicine, 5(3), 1–4.Google Scholar
  19. Ferley, J., Shin, H., Bray, F., Forman, D., Mathers, C., & Parkin, D. (2010). GLOBOCAN v1.2. Lyon France: International Agency for Research on Cancer. Retrieved from
  20. Hatahet, W., Khosla, P., & Fungwe, T. (2002). Prevalence of risk factors to coronary heart disease in an Arab-American population in southeast Michigan. International Journal of Food Sciences and Nutrition, 53(4), 325–335.PubMedCrossRefGoogle Scholar
  21. Hensley-Alford, S., Schwartz, K., Soliman, A., Cole-Johnson, C., Gruber, S., & Merajver, S. (2009). Breast cancer characteristics at diagnosis and survival among Arab-American women compared to European- and African-American women. Breast Cancer Research and Treatment, 114(2), 339–346.PubMedCrossRefGoogle Scholar
  22. Hunt, R., Xiao, S., Megraud, F., Leon-Barua, R., Bazzoli, F., van der Merwe, S., et al. (2011). Helicobacter pylori in develoing countries. World Gastroenterology Organisation Global Guideline. Journal of Gastrointestinal and Liver Diseases, 20(3), 299–304.PubMedGoogle Scholar
  23. Hyman, I. (2001). Immigration and health. Ottawa: Health Canada.Google Scholar
  24. Islam, S., & Johnson, C. (2003). Correlates of smoking behavior among Muslim Arab-American adolescents. Ethnicity & Health, 8(4), 319–337.CrossRefGoogle Scholar
  25. Jaber, L., Brown, M., Hammad, A., Zhu, Q., & Herman, W. (2004). The prevalence of the metabolic syndrome among Arab Americans. Diabetes Care, 27(1), 234–238.PubMedCrossRefGoogle Scholar
  26. Jamil, H., Templin, T., Fakhouri, M., Rice, V., Khouri, R., & Fakhouri, H. (2009). Comparison of personal characteristics, tobacco use, and health states in Chaldean, Arab American and non-Middle Eastern White adults. Journal of Immigrant and Minority Health, 11, 310–317.PubMedCrossRefGoogle Scholar
  27. John, E., Phipps, A., Davis, A., & Koo, J. (2005). Migration history, acculturation, and breast cance risk in Hispanic women. Cancer Epidemiology, Biomarkers & Prevention, 14(12), 2905–2913.CrossRefGoogle Scholar
  28. Kawar, L. (2009). Jordanian and Palestinian immigrant women’s knowledge, affect, cultural attitudes, health habits, and participant in breast cancer screening. Health Care for Women International, 30(9), 768–782.PubMedCrossRefGoogle Scholar
  29. Lee, J., Demissie, K., Lu, S., & Rhoads, G. (2007). Cancer incidence among Korean-American immigrants in the United States and nataive Koreans in South Korea. Cancer Control, 14(1), 78–85.PubMedGoogle Scholar
  30. Nanchahal, K., Mangtani, P., Alston, M., & Dos Santos Silva, I. (2001). Development and validation of computerized South Asian Names and Group Recognition Algorithm (SANGRA) for use in the British health-related studies. Journal of Public Health Medicine, 23(4), 278–285.PubMedCrossRefGoogle Scholar
  31. Nasseri, K. (2007). Construction and validation of a list of common Middle Eastern surnames for epidemiological research. Cancer Detection and Prevention, 31(5), 424–429.PubMedCrossRefGoogle Scholar
  32. Nasseri, K. (2009). Breast cancer in the MIddle Eastern population of California, 1988–2004. The Breast Journal, 15(2), 182–188.PubMedCrossRefGoogle Scholar
  33. Nasseri, K., Mills, P. K., & Allan, M. (2007). Cancer incidence in the Middle Eastern population of California, 1988–2004. Asian Pacific Journal of Cancer Prevention, 8(3), 405–411.PubMedGoogle Scholar
  34. Passel, J. S., & Word, D. L. (1980). Construction of the list of Spanish surnames for the 1980 Census: An applicatin of Bayes’ theorum.Google Scholar
  35. Peterson, L., Soliman, A., Ruterbusch, J. J., Smith, N., & Schwartz, K. (2011). Comparison of exposures among Arab American and non-Hispanic White female thyroid cancer cases in metropolitan Detroit. Journal of Immigrant Minority Health, 13(6), 1033–1040.PubMedCrossRefGoogle Scholar
  36. Razum, O., Zeeb, H., & Rohrmann, S. (2000). The ‘healthy migrant effect’—not merely a fallacy of inaccurate denominator figures. International Journal of Epidemiology, 29, 191–192.PubMedCrossRefGoogle Scholar
  37. Read, J. (2007). Alternative definitions of Mexican and Arab identity: An examination across the top three census metropolitan standard areas of concentration. Irvine: University of California.Google Scholar
  38. Rice, V., & Kulwicki, A. (1992). Cigarette use among Arab Americans in the Detroit metropolitan area. Public Health Reports, 107, 589–594.PubMedGoogle Scholar
  39. Rice, V., Weglicki, L., Templin, T., Hammad, A., Jamil, H., & Kulwicki, A. (2006). Predictors of Arab American adolescent tobacco use. Merrill-Palmer Quarterly (Wayne State University Press), 52(2), 327–342.CrossRefGoogle Scholar
  40. Schneider, K., Clark, M., Rakowski, W., & Lapane, K. (2009). Evaulating the impact of non-response bias in the Behavioral Risk Factor Surveillance System. Journal of Epidemiology and Community Health, 66(4), 290–295.CrossRefGoogle Scholar
  41. Schwartz, K., Fakhouri, M., Bartoces, M., Monsur, J., & Younis, A. (2008). Mammography screening among Arab American women in metropolitan Detroit. Journal of Immigrant Minority Health, 10(6), 541–549.PubMedCrossRefGoogle Scholar
  42. Schwartz, K., Kulwicki, A., Weiss, L. K., Fakhouri, H., Sakr, W., Kau, G., et al. (2004). Cancer among Arab Americans in the metropolitan Detroit area. Ethnicity & Disease, 14(141–146).Google Scholar
  43. Shah, S. M., Ayash, C., Pharaon, N. A., & Gany, F. M. (2008). Arab American immigrants in New York: Health care and cancer knowledge, attitudes and beliefs. Journal Immigrant Minority Health, 10(5), 429–436.CrossRefGoogle Scholar
  44. Siegel, R., Desantis, C., Virgo, K., Stein, K., Mariotto, A., Smith, T., et al. (2012). Cancer treatment and survivorship statistics, 2012. CA: A Cancer Journal for Clinicians, 62(4), 220–241.CrossRefGoogle Scholar
  45. Singh, G., & Siahpush, M. (2001). All-cause and cause-specific mortality of immigrants and native born in the United States. American Journal of Public Health, 91, 392–399.PubMedCrossRefGoogle Scholar
  46. Sykes, L., Walker, R., Ngwakongnwi, E., & Quan, H. (2010). A systematic literature review on response rates across racial and ethnic populations. Canadian Journal of Public Health, 101(3), 213–219.PubMedGoogle Scholar
  47. US Preventive Services Task Force. (2012). Recommendations for Adults: Cancer. Rockville: Agency for Healthcare Research and Policy.Google Scholar
  48. Vicini, F., Shah, C., Wallace, M., Jones, P., Dykes, V., Tull, J., et al. (2011). Strategies for reducing cancer incidence and mortality in African American and Arab American and Chaldean communities in the Detroit metropolitan area. American Journal of Clinical Oncology, 35(4), 316–21.CrossRefGoogle Scholar
  49. Weglicki, L., Templin, T., Rice, V., Jamil, H., & Hammad, A. (2008). Comparison of cigarette and water pipe smoking by Arab and non-Arab-American youth. American Journal of Preventive Medicine, 35(4), 334–339. doi: 10.1016/j.amepre.2008.06.037.PubMedCrossRefGoogle Scholar
  50. Williams, K., Mabiso, A., Todem, D., Hammad, A., Hill-Ashford, Y., Hamade, H., et al. (2011). Differences in knowledge of breast cancer screening among African American, Arab American, and Latina women. Preventing Chronic Disease, 8(1), A20.PubMedGoogle Scholar
  51. Wiseman, M. (2008). The second World Cancer Research Fund/American Institute for Cancer Research expert report. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Proceedings of the Nutrition Society, 67(3), 253–256. doi: 10.1017/S002966510800712X.PubMedCrossRefGoogle Scholar
  52. World Health Organization. (2009). 2008–2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases. Geneva, Switzerland: World Health Organization.Google Scholar
  53. World Health Organization. (2011). WHO Report on the Global Epidemic, 2011: Warning about the Dangers of Tobacco. Geneva, Switzerland: World Health Organization.Google Scholar
  54. Yassine, M. W., & Galka, A. (2006). Special cancer behavorial risk factor survey. In Michigan Cancer Consortium: Michigan Public Health Institute (Ed.) available at
  55. Yassine, M. W., & Galka, A. (2010). Special Cancer Behavioral Risk Factor Survey, 2008Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Kendra Schwartz
    • 1
  • Kiumarss Nasseri
    • 2
  • Emad Shehada
    • 3
  1. 1.Department of Family Medicine and Public Health SciencesDetroitUSA
  2. 2.Department of Epidemiology and Biostatistics, School of Public HealthMedical Sciences University of TehranSanta BarbaraUSA
  3. 3.Division of Pulmonary and Critical Care MedicineDepartment of Internal MedicineDetroitUSA

Personalised recommendations