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Cervical Cancer Among Asian Americans

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Cancer Epidemiology Among Asian Americans

Abstract

Cervical cancer is a leading cause of female cancers worldwide. Infection with one or more of the carcinogenic types of human papillomavirus (HPV) is considered to be a necessary, but insufficient cause of cervical cancer. Other coinfections, cigarette smoking, and hormonal influences of pregnancy and oral contraceptive use appear to synergistically increase the risk of HPV-associated cervical cancer progression. Geographical and ethnic variation in cervical cancer incidence may thus reflect differences in exposure to HPV due to different sexual mores or susceptibility to infection, differences in prevalence of cofactors, or differences in the availability or effectiveness of cervical cancer prevention programs such as Pap smear and HPV screening. Although the incidence of cervical cancer in Asian Americans is lower than the other racial/ethnic groups in the USA, incidence rates are heterogeneous among different Asian ethnic groups, which may be related to the level of endemicity of high-risk HPV types in the Asian countries of origin, with some variation in findings potentially related to selective socioeconomic migration of immigrants. It is unclear how screening influences cervical cancer survival because Asian Americans lag systematically behind the general US population in screening uptake. The lack of knowledge of the benefits of early detection and screening guidelines, cultural factors, and access barriers is associated with the low screening rates. Similar disparities, and their driving forces, result in insufficient HPV immunization, similar to the low screening coverage reported in Asian-American communities. Future dissemination of effective culturally appropriate educational intervention programs for the reduction of access barriers shows great promise in reducing previous cervical cancer disparities in Asian-American women.

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References

  1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386

    Article  CAS  PubMed  Google Scholar 

  2. Siegel RL, Miller KD, Jemal A (2015) Cancer statistics, 2015. CA Cancer J Clin 65:5–29

    Article  PubMed  Google Scholar 

  3. Wang SS, Carreon JD, Gomez SL, Devesa SS (2010) Cervical cancer incidence among 6 Asian ethnic groups in the United States, 1996 through 2004. Cancer 116:949–956

    Article  PubMed  Google Scholar 

  4. Miller BA, Chu KC, Hankey BF, Ries LA (2008) Cancer incidence and mortality patterns among specific Asian and Pacific islander populations in the U.S. Cancer Causes Control 19:227–256

    Article  PubMed  Google Scholar 

  5. Gomez SL, Noone AM, Lichtensztajn DY, Scoppa S, Gibson JT, Liu L et al (2013) Cancer incidence trends among Asian American populations in the United States, 1990–2008. J Natl Cancer Inst 105:1096–1110

    Article  PubMed  PubMed Central  Google Scholar 

  6. Jemal A, Simard EP, Dorell C, Noone AM, Markowitz LE, Kohler B et al (2013) Annual Report to the Nation on the Status of Cancer, 1975–2009, featuring the burden and trends in human papillomavirus (HPV)-associated cancers and HPV vaccination coverage levels. J Natl Cancer Inst 105:175–201

    Article  PubMed  PubMed Central  Google Scholar 

  7. Guan P, Howell-Jones R, Li N, Bruni L, de Sanjose S, Franceschi S et al (2012) Human papillomavirus types in 115,789 HPV-positive women: a meta-analysis from cervical infection to cancer. Int J Cancer 131:2349–2359

    Article  CAS  PubMed  Google Scholar 

  8. Rositch AF, Nowak RG, Gravitt PE (2014) Increased age and race-specific incidence of cervical cancer after correction for hysterectomy prevalence in the United States from 2000 to 2009. Cancer 120:2032–2038

    Article  PubMed  PubMed Central  Google Scholar 

  9. Moscicki AB, Schiffman M, Burchell A, Albero G, Giuliano AR, Goodman MT et al (2012) Updating the natural history of human papillomavirus and anogenital cancers. Vaccine 30(Suppl 5):F24–F33

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gravitt PE (2011) The known unknowns of HPV natural history. J Clin Invest 121:4593–4599

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Gage JC, Schiffman M, Katki HA, Castle PE, Fetterman B, Wentzensen N et al (2014) Reassurance against future risk of precancer and cancer conferred by a negative human papillomavirus test. J Natl Cancer Inst 106, pii: dju153

    Article  Google Scholar 

  12. Saslow D, Solomon D, Lawson HW, Killackey M, Kulasingam SL, Cain J et al (2012) American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin 62:147–172

    Article  PubMed  PubMed Central  Google Scholar 

  13. Maucort-Boulch D, Franceschi S, Plummer M, Group IHPSS (2008) International correlation between human papillomavirus prevalence and cervical cancer incidence. Cancer Epidemiol Biomarkers Prev 17:717–720

    Article  PubMed  Google Scholar 

  14. Munoz N, Bosch FX, de Sanjose S, Herrero R, Castellsague X, Shah KV et al (2003) Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 348:518–527

    Article  PubMed  Google Scholar 

  15. Chen HC, Schiffman M, Lin CY, Pan MH, You SL, Chuang LC et al (2011) Persistence of type-specific human papillomavirus infection and increased long-term risk of cervical cancer. J Natl Cancer Inst 103:1387–1396

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Cornet I, Gheit T, Franceschi S, Vignat J, Burk RD, Sylla BS et al (2012) Human papillomavirus type 16 genetic variants: phylogeny and classification based on E6 and LCR. J Virol 86:6855–6861

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Yamada T, Manos MM, Peto J, Greer CE, Munoz N, Bosch FX et al (1997) Human papillomavirus type 16 sequence variation in cervical cancers: a worldwide perspective. J Virol 71:2463–2472

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Quint KD, de Koning MN, van Doorn LJ, Quint WG, Pirog EC (2010) HPV genotyping and HPV16 variant analysis in glandular and squamous neoplastic lesions of the uterine cervix. Gynecol Oncol 117:297–301

    Article  CAS  PubMed  Google Scholar 

  19. Xi LF, Koutsky LA, Hildesheim A, Galloway DA, Wheeler CM, Winer RL et al (2007) Risk for high-grade cervical intraepithelial neoplasia associated with variants of human papillomavirus types 16 and 18. Cancer Epidemiol Biomarkers Prev 16:4–10

    Article  CAS  PubMed  Google Scholar 

  20. Cornet I, Gheit T, Iannacone MR, Vignat J, Sylla BS, Del Mistro A et al (2013) HPV16 genetic variation and the development of cervical cancer worldwide. Br J Cancer 108:240–244

    Article  CAS  PubMed  Google Scholar 

  21. Zehbe I, Richard C, DeCarlo CA, Shai A, Lambert PF, Lichtig H et al (2009) Human papillomavirus 16 E6 variants differ in their dysregulation of human keratinocyte differentiation and apoptosis. Virology 383:69–77

    Article  CAS  PubMed  Google Scholar 

  22. Niccoli S, Abraham S, Richard C, Zehbe I (2012) The Asian-American E6 variant protein of human papillomavirus 16 alone is sufficient to promote immortalization, transformation, and migration of primary human foreskin keratinocytes. J Virol 86:12384–12396

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Jackson R, Togtema M, Lambert PF, Zehbe I (2014) Tumourigenesis driven by the human papillomavirus type 16 Asian-American e6 variant in a three-dimensional keratinocyte model. PLoS One 9, e101540

    Article  PubMed  PubMed Central  Google Scholar 

  24. Burk RD, Terai M, Gravitt PE, Brinton LA, Kurman RJ, Barnes WA et al (2003) Distribution of human papillomavirus types 16 and 18 variants in squamous cell carcinomas and adenocarcinomas of the cervix. Cancer Res 63:7215–7220

    CAS  PubMed  Google Scholar 

  25. Bruni L, Barrionuevo-Rosas L, Albero G, et al. ICO Information Centre on HPV and Cancer (HPV Information Center). Summary Report 2015;2015-03-24. Accessed 19 May 2015.

    Google Scholar 

  26. Vaccarella S, Franceschi S, Clifford GM, Touze A, Hsu CC, de Sanjose S et al (2010) Seroprevalence of antibodies against human papillomavirus (HPV) types 16 and 18 in four continents: the International Agency for Research on Cancer HPV Prevalence Surveys. Cancer Epidemiol Biomarkers Prev 19:2379–2388

    Article  CAS  PubMed  Google Scholar 

  27. Le GM, Gomez SL, Clarke CA, Glaser SL, West DW (2002) Cancer incidence patterns among Vietnamese in the United States and Ha Noi, Vietnam. Int J Cancer 102:412–417

    Article  CAS  PubMed  Google Scholar 

  28. Shi JF, Canfell K, Lew JB, Qiao YL (2012) The burden of cervical cancer in China: synthesis of the evidence. Int J Cancer 130:641–652

    Article  CAS  PubMed  Google Scholar 

  29. Javanbakht M, Gorbach PM, Amani B, Walker S, Cranston RD, Datta SD et al (2010) Concurrency, sex partner risk, and high-risk human papillomavirus infection among African American, Asian, and Hispanic women. Sex Transm Dis 37:68–74

    Article  PubMed  Google Scholar 

  30. Pham TH, Nguyen TH, Herrero R, Vaccarella S, Smith JS, Nguyen Thuy TT et al (2003) Human papillomavirus infection among women in South and North Vietnam. Int J Cancer 104:213–220

    Article  PubMed  Google Scholar 

  31. International Collaboration of Epidemiological Studies of Cervical Cancer (2006) Cervical carcinoma and reproductive factors: collaborative reanalysis of individual data on 16,563 women with cervical carcinoma and 33,542 women without cervical carcinoma from 25 epidemiological studies. Int J Cancer 119:1108–1124

    Article  Google Scholar 

  32. Castellsague X, Diaz M, de Sanjose S, Munoz N, Herrero R, Franceschi S et al (2006) Worldwide human papillomavirus etiology of cervical adenocarcinoma and its cofactors: implications for screening and prevention. J Natl Cancer Inst 98:303–315

    Article  PubMed  Google Scholar 

  33. International Collaboration of Epidemiological Studies of Cervical Cancer, Appleby P, Beral V, de Gonzalez Berrington A, Colin D, Franceschi S et al (2007) Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies. Lancet 370:1609–1621

    Article  Google Scholar 

  34. International Collaboration of Epidemiological Studies of Cervical Cancer, Appleby P, Beral V, de Gonzalez Berrington A, Colin D, Franceschi S et al (2006) Carcinoma of the cervix and tobacco smoking: collaborative reanalysis of individual data on 13,541 women with carcinoma of the cervix and 23,017 women without carcinoma of the cervix from 23 epidemiological studies. Int J Cancer 118:1481–1495

    Article  Google Scholar 

  35. Smith JS, Herrero R, Bosetti C, Munoz N, Bosch FX, Eluf-Neto J et al (2002) Herpes simplex virus-2 as a human papillomavirus cofactor in the etiology of invasive cervical cancer. J Natl Cancer Inst 94:1604–1613

    Article  CAS  PubMed  Google Scholar 

  36. Smith JS, Bosetti C, Munoz N, Herrero R, Bosch FX, Eluf-Neto J et al (2004) Chlamydia trachomatis and invasive cervical cancer: a pooled analysis of the IARC multicentric case–control study. Int J Cancer 111:431–439

    Article  CAS  PubMed  Google Scholar 

  37. Arnheim Dahlstrom L, Andersson K, Luostarinen T, Thoresen S, Ogmundsdottir H, Tryggvadottir L et al (2011) Prospective seroepidemiologic study of human papillomavirus and other risk factors in cervical cancer. Cancer Epidemiol Biomarkers Prev 20:2541–2550

    Article  PubMed  Google Scholar 

  38. Castellsague X, Pawlita M, Roura E, Margall N, Waterboer T, Bosch FX et al (2014) Prospective seroepidemiologic study on the role of Human Papillomavirus and other infections in cervical carcinogenesis: evidence from the EPIC cohort. Int J Cancer 135:440–452

    Article  CAS  PubMed  Google Scholar 

  39. Ries LA, Eisner MP, Kosary CL, et al. SEER Cancer Statistics Review, 1975–2000. http://seer.cancer.gov/csr/1975_2000/2003

  40. (USPSTF) USPSTF (2012). Screening for Cervical Cancer, Topic Page. http://www.uspreventiveservicestaskforce.org/uspset/uspscerv.htm

  41. Kim K, Yu ES, Chen EH, Kim J, Kaufman M, Purkiss J (1999) Cervical cancer screening knowledge and practices among Korean-American women. Cancer Nurs 22:297–302

    Article  CAS  PubMed  Google Scholar 

  42. McPhee SJ, Bird JA, Davis T, Ha NT, Jenkins CN, Le B (1997) Barriers to breast and cervical cancer screening among Vietnamese-American women. Am J Prev Med 13:205–213

    CAS  PubMed  Google Scholar 

  43. McPhee SJ, Stewart S, Brock KC, Bird JA, Jenkins CN, Pham GQ (1997) Factors associated with breast and cervical cancer screening practices among Vietnamese American women. Cancer Detect Prev 21:510–521

    CAS  PubMed  Google Scholar 

  44. Taylor VM, Yasui Y, Burke N, Nguyen T, Acorda E, Thai H et al (2004) Pap testing adherence among Vietnamese American women. Cancer Epidemiol Biomarkers Prev 13:613–619

    PubMed  Google Scholar 

  45. Ma GX, Toubbeh JI, Wang MQ, Shive SE, Cooper L, Pham A (2009) Factors associated with cervical cancer screening compliance and noncompliance among Chinese, Korean, Vietnamese, and Cambodian women. J Natl Med Assoc 101:541–551

    Article  PubMed  Google Scholar 

  46. Fang CY, Ma GX, Tan Y, Chi N (2007) A multifaceted intervention to increase cervical cancer screening among underserved Korean women. Cancer Epidemiol Biomarkers Prev 16:1298–1302

    Article  PubMed  Google Scholar 

  47. Ma GX, Gao W, Fang CY, Tan Y, Feng Z, Ge S et al (2013) Health beliefs associated with cervical cancer screening among Vietnamese Americans. J Womens Health (Larchmt) 22:276–288

    Article  Google Scholar 

  48. Ma GX, Shive SE, Wang MQ, Tan Y (2009) Cancer screening behaviors and barriers in Asian Americans. Am J Health Behav 33:650–660

    Article  PubMed  Google Scholar 

  49. Ma GX, Fang CY, Feng Z, Tan Y, Gao W, Ge S et al (2012) Correlates of cervical cancer screening among Vietnamese American women. Infect Dis Obstet Gynecol 2012:617234

    Article  PubMed  PubMed Central  Google Scholar 

  50. American Cancer Society (2012) Cancer prevention and early detection: facts and figures. American Cancer Society, Atlanta, GA. http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-033423.pdf.

  51. (ODPHP) OoDPaP (2012) Healthy People 2020. http://www.healthypeople.gov.

  52. Juon HS, Seung-Lee C, Klassen AC (2003) Predictors of regular Pap smears among Korean-American women. Prev Med 37:585–592

    Article  PubMed  Google Scholar 

  53. Coughlin SS, Uhler RJ (2000) Breast and cervical cancer screening practices among Asian and Pacific Islander women in the United States, 1994–1997. Cancer Epidemiol Biomarkers Prev 9:597–603

    CAS  PubMed  Google Scholar 

  54. Kim HLK, Lee SO, Kim S (2004) Cervical cancer screening in Korean American women: findings from focus group intervention. Taehan Kanho Hakhoe Chi 34:617–624

    PubMed  Google Scholar 

  55. Lee EE, Tripp-Reimer T, Miller AM, Sadler GR, Lee SY (2007) Korean American women's beliefs about breast and cervical cancer and associated symbolic meanings. Oncol Nurs Forum 34:713–720

    Article  PubMed  PubMed Central  Google Scholar 

  56. Jenkins CN, McPhee SJ, Bird JA, Pham GQ, Nguyen BH, Nguyen T et al (1999) Effect of a media-led education campaign on breast and cervical cancer screening among Vietnamese-American women. Prev Med 28:395–406

    Article  CAS  PubMed  Google Scholar 

  57. Ma GX, Fang C, Tan Y, Feng Z, Ge S, Nguyen C (2015) Increasing cervical cancer screening among Vietnamese Americans: a community-based intervention trial. J Health Care Poor Underserved 26:36–52

    Article  PubMed  Google Scholar 

  58. Mock J, McPhee SJ, Nguyen T, Wong C, Doan H, Lai KQ et al (2007) Effective lay health worker outreach and media-based education for promoting cervical cancer screening among Vietnamese American women. Am J Public Health 97:1693–1700

    Article  PubMed  PubMed Central  Google Scholar 

  59. Nguyen TT, McPhee SJ, Gildengorin G, Nguyen T, Wong C, Lai KQ et al (2006) Papanicolaou testing among Vietnamese Americans: results of a multifaceted intervention. Am J Prev Med 31:1–9

    Article  PubMed  Google Scholar 

  60. Ma GX, Tan Y, Toubbeh JI, Edwards RL, Shive SE, Siu P et al (2006) Asian Tobacco Education and Cancer Awareness Research Special Population Network. A model for reducing Asian American cancer health disparities. Cancer 107:1995–2005

    Article  PubMed  Google Scholar 

  61. Taylor VM, Hislop TG, Jackson JC, Tu SP, Yasui Y, Schwartz SM et al (2002) A randomized controlled trial of interventions to promote cervical cancer screening among Chinese women in North America. J Natl Cancer Inst 94:670–677

    Article  PubMed  PubMed Central  Google Scholar 

  62. Wang X, Fang C, Tan Y, Liu A, Ma GX (2010) Evidence-based intervention to reduce access barriers to cervical cancer screening among underserved Chinese American women. J Womens Health (Larchmt) 19:463–469

    Article  CAS  Google Scholar 

  63. Lee MC (2000) Knowledge, barriers, and motivators related to cervical cancer screening among Korean-American women. A focus group approach. Cancer Nurs 23:168–175

    Article  CAS  PubMed  Google Scholar 

  64. Organization WH. (2011) United Nations Population Fund (2006) Preparing for the Introduction of HPV vaccines: policy and programming guidance for countries. Available at: http://whqlibdoc.who.int/hq/2006/WHO.RHR_06-11/eng.pdf. Assessed 16 May 2011.

  65. (CDC) USCfDC (2007) Quadrivalent human papillomavirus vaccine: recommendation of the Advisory Committee on Immunization Practices (ACIP). MMWR.56 (No. RR-2).

    Google Scholar 

  66. (CDC) USCfDC. FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and update HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP). MMWR 2010;59L626-9.

    Google Scholar 

  67. Control USCfD (2010) FDA licensure of quadrivalent human papillomavirus vaccine (HPV4, Gardasil) for use in males and guidance from the Advisory Committee on Immunization Practices (ACIP). MMWR 59: 630–2.

    Google Scholar 

  68. Bastani R, Glenn BA, Tsui J, Chang LC, Marchand EJ, Taylor VM et al (2011) Understanding suboptimal human papillomavirus vaccine uptake among ethnic minority girls. Cancer Epidemiol Biomarkers Prev 20:1463–1472

    Article  PubMed  PubMed Central  Google Scholar 

  69. Yi JK, Anderson KO, Le YC, Escobar-Chaves SL, Reyes-Gibby CC (2013) English proficiency, knowledge, and receipt of HPV vaccine in Vietnamese-American women. J Community Health 38:805–811

    Article  PubMed  Google Scholar 

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Financial Disclosures

Authors’ declaration of personal interests: PEG, RHNN, and GXM have no personal interest in preparing this chapter.

Declaration of funding interests: PEG, RHNN, and GXM had no specific funding support related to the preparation of this manuscript.

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Correspondence to Patti E. Gravitt Ph.D., M.S. .

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Gravitt, P.E., Nguyen, R.H.N., Ma, G.X. (2016). Cervical Cancer Among Asian Americans. In: Wu, A., Stram, D. (eds) Cancer Epidemiology Among Asian Americans. Springer, Cham. https://doi.org/10.1007/978-3-319-41118-7_12

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