Pancreatic cancer risks are greater for Hawaiians, Japanese Americans

Native Hawaiians and Japanese Americans face greater risks of pancreatic cancer, according to a recent study by the University of Southern California, the University of Hawaii and others.

The study looked at different ethnic groups and risk factors that contribute to pancreatic cancer, and showed that Native Hawaiians have a 60% greater risk of pancreatic cancer than European Americans, while Japanese Americans showed a 33% greater risk.

“When you take into account smoking, diabetes, red meat intake and family history of pancreatic cancer, you explain some of the differences but not all of them,” said Loic Le Marchand, an epidemiologist with the University of Hawaii Cancer Center and co-author of the study. “Ethnic differences remain when taking into account known risk factors of pancreatic cancer.”

More than 180 people in Hawaii die from pancreatic cancer every year, and there are more than 220 new diagnoses, according to the UH Cancer Center Hawaii Tumor Registry.

“It’s a very lethal disease, about 8% survival rate of five years only,” Le Mar­chand said. “And there are no markers, no ways, no screening tests, really, to detect tumors early when they could be cured.”

Hawaii Congressman Mark Takai died in 2016 at age 49 after a battle with pancreatic cancer, nine months after his diagnosis.

Alex Trebek, host of the game show “Jeopardy,” said in March he had been diagnosed with stage 4 pancreatic cancer. He reported last week that his cancer is responding well to treatment and that some tumors have shrunk by more than 50%.

The UH Cancer Center noted that of all the ethnic groups in Hawaii, Native Hawaiians have the highest mortality rate from pancreatic cancer.

The study included more than 20 years of data from more than 180,000 participants, who were categorized as Japanese Americans, European Americans, Latino Americans, African Americans and Native Hawaiians and were recruited from Los Angeles County and Hawaii.

Native Hawaiians had the highest risk, followed by Japanese Americans, African Americans (20%) and Latino Americans, whose risk was similar to European Americans.

Previous studies had shown the increased risk of pancreatic cancer in African Americans, but there was little data regarding other ethnic groups.

“This study clearly shows that native Hawaiians and Japanese Americans have a higher risk of pancreatic cancer relative to whites, which has never been highlighted before,” said Veronica Wendy Setiawan, associate professor of preventive medicine at the Keck School of Medicine at USC and one of the study’s co-authors. “Particularly because studies in minorities are lacking or studies tend to group them as one big group: ‘Asians’ or ‘Asians/Pacific Islander.’”

The study also showed that Native Hawaiians, along with African Americans, ate more red meat and were more likely to smoke and have diabetes — all risk factors for pancreatic cancer.

“Knowing that a sizable proportion of pancreatic cancer (20%) can be attributed to modifiable risk factors (smoking, obesity, red meat intake) is also important,” Setiawan said. “That means those cancers can be prevented.”

There also could be a genetic component to pancreatic cancer.

“The fact that family history of pancreatic cancer was a stronger risk factor among Japanese Americans than among European Americans suggests that genetics may play a more substantial role in defining risk between race/ethnicity groups,” the study said.

In ongoing research, one common factor between Native Hawaiians and Japanese Americans, Le Marchand said, was that both groups had higher levels of dissolved intra-abdominal fat. Native Hawaiians had the highest amount of fat in the pancreas, which has shown to be a risk factor for pancreatic cancer.

Native Hawaiians and other Pacific Islanders (NHOPIs) have among the highest risk of cardiometabolic disorders, which include cardiovascular disease, diabetes, and obesity, in the country.

NHOPIs, who make up about 27% of Hawaii’s population, are three times more likely to be obese than the overall Asian American population, according to the U.S. Department of Health and Human Services’ Office of Minority Health.

The findings in the study support already well-established health disparities among NHOPIs in Hawaii, which nevertheless continues to find itself ranked among the healthiest states in the country.

“If you take a 20,000-foot view of things, a global view of things, yes, our numbers are pretty good in terms of health,” Le Marchand said. “A good proportion of the population has health insurance and has had for a good number of years, but when you really do the comparison across ethnic groups, you do find the disparities, and obviously they should be addressed.”