Filipino newcomers to Canada diagnosed with breast cancer at a younger age
Filipinos who move to Canada are diagnosed with breast cancer at a younger age than women from other parts of East Asia or Caucasians, new research has found.
They are also more likely to be diagnosed with a more aggressive form of cancer and are more likely to undergo a mastectomy, according to a paper published online in the Journal of Immigrant and Minority Health.
“The Canadian Filipino community is a growing community and this new research raises the question of whether our current Canadian guidelines calling for mammograms starting at age 50 are meeting specific cultural needs of different ethnicities when it is known that it takes years for a breast cancer to develop,” said Dr. Jory Simpson, a surgical oncologist in the CIBC Breast Centre of St. Michael’s Hospital.
“As Canada continues to ethnically diversify this new research only highlights and magnifies the need to take on a more personalized approach to preventing and treating breast cancer.”
Dr. Simpson said it’s known that women of different ethnic origins have different risks of developing breast cancer. When a women emigrates from an area of low incidence of breast cancer to an area of high incidence, her risk increases, possibly due to new environmental influences such as diet interacting with preexisting genetics.
Dr. Simpson said he believes his study - albeit a small sample at one hospital - is the first to look at the incidence of breast cancer in Filipino immigrants to Canada. According to Statistics Canada, Filipinos are the third largest non-European ethnic group in the country. Of the 328,000 people of Filipino origin who live in Canada, many are young women.
October is Breast Cancer Awareness Month, and many countries in the world, including the Philippines, are planning a set of activities in line with this event. Everyone is encouraged to participate by helping to raise funds for research and indigent patients, volunteering to help those battling the disease in any way you can or simply educating yourself on breast cancer prevention and treatment.
The Philippines is at the center of the fight against breast cancer in Asia. The country has the highest incidence of breast cancer in the continent and an estimated 3 out of 100 Filipino women will contract the disease before age 75; 1 out of 100 will die before age 75, according to the Philippine Society of Medical Oncology in 2012. This complements the Department of Health and Philippine Cancer Society, Inc. report, which states that breast cancer is the most common cancer in the country, comprising 16 percent of the 80,000 new cancer cases in 2010.
Early detection is still considered the best weapon in combating the disease. Routine self-breast examinations, mammograms and vigilance in observing changes in the physical form of the breasts and nipples are key to preventing the disease from advancing. Other factors in lowering one’s risk are limiting alcohol intake, no smoking, controlling one’s weight, exercising, limiting the dose and duration of hormone therapy, and the avoidance of exposure to pollution and radioactive substances. Also among the many advantages of breastfeeding is that it lowers incidence of breast cancer.
Of the 782 patients he studied at St. Michael’s, which has a sizeable Filipino patient population, Filipino newcomers to Canada were diagnosed with breast cancer at a younger age (53) compared to other East Asians (55) and Caucasians (58).
They were also found to be diagnosed with a form of more aggressive cancer and have a higher likelihood of undergoing a mastectomy. Thirty-seven per cent had a Grade 3 tumour on a scale of 1-3, compared to less than 30 per cent for other Asians and Caucasians. In addition, 22.6 per cent tested positive for the protein HER2, or human epidermal growth factor receptor 2, which promotes the growth of cancer cells. Dr. Simpson said that was “disproportionately high” compared to East Asians (14.4 per cent) and Caucasians (15.1 per cent).
Eating soy during adolescence may reduce breast cancer - University of Southern California study shows link between diet and cancer in Asian-American women
Eating soy foods on a regular basis-especially during adolescence-might lower the risk of breast cancer, according to preventive medicine researchers at the Keck School of Medicine of USC and colleagues.
Asian-American women who consumed soy foods on a weekly basis during their teen years and adulthood had about half the risk of developing breast cancer compared to similar women who ate little soy during the same time periods, according to a study in the September issue of Carcinogenesis.
Risk also was somewhat lowered for women who ate soy regularly during the teen years but consumed little during adulthood. However, preliminary data suggest little added benefit for women who ate little soy during adolescence but a high amount of soy during adulthood.
“There has been a lot of talk and controversy about the Asian diet and connections between soy food intake and breast cancer. We wanted to look at soy very carefully, to better understand if soy by itself is protective or if the level of soy consumption is just a marker for acculturation,” says Anna H. Wu, Ph.D. professor of preventive medicine at the Keck School of Medicine.
Wu and colleagues conducted a case-control study of breast cancer among Chinese, Japanese and Filipino women in Los Angeles County, specifically looking at the importance of soy. From 1995 to 1998, they interviewed 501 Asian-American breast cancer patients and compared them to 594 healthy Asian-American women.
The researchers asked about eating habits, including how many times each week during adolescence they ate tofu. They also asked about the frequency and amounts of whole soy foods, such as tofu, soymilk, miso and fresh soybeans, usually eaten during adulthood.
Intake was highest among Chinese (26.8 milligrams of isoflavones a day), intermediate among Japanese (18.4 mg of isoflavones a day) and lowest among Filipinas (9.3 mg of isoflavones a day). Migrants ate a little more soy than American-born women did. Most of the Chinese and Filipino women in this study-more than 90 percent-were born in Asia, compared to less than 30 percent of the Japanese women.
Filipino women with tumours the same size as their East Asian and Caucasian counterparts underwent more mastectomies in this study, 35 per cent, compared with 22.5 per cent for Caucasian woman and 28.3 per cent for East Asian women.
About St. Michael’s Hospital
St Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
For more information, or to arrange an interview with Dr. Simpson, contact:
Leslie Shepherd, Manager, Media Strategy
St. Michael’s Hospital
St. Michael’s Hospital
Journal of Immigrant and Minority Health