Armenian immigrants are classified as “white” people in USA but found to have disproportionately higher stomach cancer than white people

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Abstract​

Introduction​

California is home to the largest population of Armenians in the United States. The historical categorization of Armenians as ‘White’ or ‘Some Other Race’ in population databases has likely masked cancer incidence patterns in this population. This is the first study considering cancer incidence among Armenians in California.

Methods​

We used the Armenian Surname List and birthplace information in the California Cancer Registry to identify Armenians with cancer diagnosed during 1988–2019. We calculated proportional incidence ratios (PIR) among Armenians compared with non‐Hispanic Whites (NHWs). As an exploratory analysis, we calculated incidence rate ratios (IRR) during 2006–2015 using Armenian population denominators from the American Community Survey (ACS). We selected PIR as our primary method given uncertainty regarding the use of ACS population estimates for rate calculations.

Results​

There were 27,212 cancer diagnoses among Armenians in California, 13,754 among males and 13,458 among females. Armenian males had notably higher proportions of stomach (PIR = 2.39), thyroid (PIR = 1.45), and tobacco‐related cancers including bladder (PIR = 1.53), colorectal (PIR = 1.29), and lung (PIR = 1.16) cancers. Higher proportional incidence of cancers including stomach (PIR = 3.24), thyroid (PIR = 1.47), and colorectal (PIR = 1.29) were observed among Armenian females. Exploratory IRR analyses showed higher stomach (IRR = 1.78), bladder (IRR = 1.13), and colorectal (IRR = 1.12) cancers among Armenian males and higher stomach (IRR = 2.54) cancer among Armenian females.

Conclusion​

We observed higher stomach, colorectal and thyroid cancer incidence among males and females, and tobacco‐related cancers among males. Further research is needed to refine Armenian population estimates and understand and address risk factors associated with specific cancers among Armenians in California.

Keywords: Armenian, California, cancer, incidence, proportion

 

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Short abstract​

We observed higher stomach, colorectal and thyroid cancer incidence among males and females and tobacco‐related cancers among males. Further research is needed to refine Armenian population estimates and understand and address risk factors associated with specific cancers among Armenians in California.
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1. INTRODUCTION​

California is the largest and most diverse state in the United States, 1 , 2 and home to the largest population of Armenians in the United States, with immigration to the state dating back to the 1870s. 3 , 4 Given California's racial and ethnic diversity, numerous recent research studies have focused on cancer occurrence patterns in specific ethnic groups, including Hispanic, Asian, Middle‐Eastern, and Arab populations in California. 5 , 6 , 7 , 8 , 9 However, Armenians remain unrepresented in public health and epidemiological research due to their categorization as ‘White’ or ‘Some Other Race’ in population databases. 3 , 10 , 11
Prior studies on cancer occurrence among Middle‐Eastern populations in California included the Armenian population and found proportionally higher stomach and thyroid cancers and proportionally lower lung and cervical cancers among Middle‐Eastern females compared with non‐Hispanic White (NHW) females. 9 , 12 In addition, proportionally higher thyroid, bladder, and stomach cancers and lower lung cancer were observed among Middle‐Eastern males compared with NHW males. 9 , 13 While Armenians were included in the broad Middle‐Eastern group, cancer risk factors, including tobacco‐use, are higher in Armenia compared to surrounding countries and cancer mortality rates in Armenia are notably higher than neighboring Middle‐Eastern countries, such as Iran and Iraq. 14 , 15 Additionally, a hospital in Los Angeles county, where the majority of Armenians in California reside, found that a majority of their patients with stomach cancer were Armenian. 16 However, state‐level analyses of cancer incidence by cancer type and sex among the Armenian population in California and in the United States have remained unknown, and it is unclear whether cancer patterns among Armenians differ from the NHW population with which they have been historically categorized in population‐based research studies. 11 , 17
No prior studies, to our knowledge, have studied cancer incidence specifically among the Armenian population in California. 18 Therefore, we utilized the recently developed Armenian Surname List (ASL) 17 and birthplace data in the population‐based California Cancer Registry to identify Armenians with cancer. Research on this growing minority group in California can reveal the cancers disproportionately impacting Armenians.

 

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So Armenians in California with significantly higher IRRs and PIRs of stomach cancer observed among Armenian males and females means significantly higher proportion of stomach cancer and significantly higher risk of stomach cancer incidence than non Hispanic white people in USA.