title: Incidence trends of lung cancer by immigration status among Chinese Americans.
abstract: BACKGROUND
  Lung cancer is the leading cause of cancer-related death among Chinese Americans. A detailed examination of incidence trends by immigration status and histology may inform the etiology of lung cancer in this growing population.
  
  
  METHODS
  California Cancer Registry data were enhanced with data on patient nativity. Lung cancer incidence rates for Chinese males and females were computed for the years 1990-2010, and rates by immigration status and histology were computed for 1990-2004. Trends were assessed with annual percentage change (APC) statistics (two-sided P values) based on linear regression.
  
  
  RESULTS
  A total of 8,167 lung cancers were diagnosed among California Chinese from 1990 to 2010. Overall incidence increased nonstatistically among U.S.-born males (APC, 2.1; 95% CI, -4.9 to 9.7), but decreased significantly among foreign-born (APC, -1.7; 95% CI, -2.9 to -0.6). Statistically significant decreasing trends were observed for non-small cell lung cancer (NSCLC), specifically the squamous cell and large cell carcinoma subtypes among foreign-born males. Among females, incidence decreased nonsignificantly among U.S.-born (APC, -2.8; 95% CI, -9.1 to 4.0) but was stable among foreign-born (APC, -0.4; 95% CI, -1.7 to 1.0). A statistically significant decreasing trend was observed for squamous cell among foreign-born females.
  
  
  CONCLUSIONS
  These data provide critical evidence base to inform screening, research, and public health priorities in this growing population.
  
  
  CONCLUSIONS
  Given the low smoking prevalence among Chinese Americans, especially females, and few known lung cancer risk factors in U.S. never-smoker populations, additional research of etiologic genetic or biologic factors may elucidate knowledge regarding lung cancer diagnosed in never smokers.
authors.affiliation: Cancer Prevention Institute of California, Fremont, California. Department of Health Research and Policy (Epidemiology), Stanford School of Medicine, Stanford, California. Stanford Cancer Institute, Palo Alto, California. scarlett.gomez@cpic.org.
authors.forename: Scarlett Lin
authors.initials: SL
authors.lastname: Gomez
authors.affiliation: Cancer Prevention Institute of California, Fremont, California.
authors.forename: Juan
authors.initials: J
authors.lastname: Yang
authors.affiliation: Genentech, South San Francisco, CA.
authors.forename: Shih-Wen
authors.initials: SW
authors.lastname: Lin
authors.affiliation: Genentech, South San Francisco, CA.
authors.forename: Margaret
authors.initials: M
authors.lastname: McCusker
authors.affiliation: Genentech, South San Francisco, CA.
authors.forename: Alan
authors.initials: A
authors.lastname: Sandler
authors.affiliation: Cancer Prevention Institute of California, Fremont, California. Stanford Cancer Institute, Palo Alto, California.
authors.forename: Iona
authors.initials: I
authors.lastname: Cheng
authors.affiliation: Stanford Cancer Institute, Palo Alto, California.
authors.forename: Heather A
authors.initials: HA
authors.lastname: Wakelee
authors.affiliation: Stanford Cancer Institute, Palo Alto, California.
authors.forename: Manali
authors.initials: M
authors.lastname: Patel
authors.affiliation: Cancer Prevention Institute of California, Fremont, California. Department of Health Research and Policy (Epidemiology), Stanford School of Medicine, Stanford, California. Stanford Cancer Institute, Palo Alto, California.
authors.forename: Christina A
authors.initials: CA
authors.lastname: Clarke
mesh_terms: D000368:Aged; D001213:Asian; D004641:Emigration and Immigration / Q000639:trends*; D005260:Female; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged