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Cancer remains the leading cause of death for Asian Americans, with multiple gastrointestinal malignancies among the top incident and fatal cancers. Existing research often groups Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) together, obscuring substantial heterogeneity across origin groups and limiting efforts to identify and address health disparities. This personal view presents disaggregated gastrointestinal cancer incidence and mortality where feasible, highlights gaps in screening practices, and argues for moving from broad racial categories toward high-quality, origin-group data to clarify differential cancer risks.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/shattering-the-monolith-burden-of-gastrointestinal-cancer-in-asian-americans-native-hawaiians-and-pacific-islanders-in-the-united-states/331611/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/shattering-the-monolith-burden-of-gastrointestinal-cancer-in-asian-americans-native-hawaiians-and-pacific-islanders-in-the-united-states/331611.png","ImageObject",300,407,{"name":92,"@type":93},"Clementine","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why does the article argue that broad AANHPI categories are insufficient for cancer research?","Question",{"text":112,"@type":113},"Broad categories (“AANHPI”) hide major differences across origin groups in lifestyle, diet, cultural practices, health beliefs, socioeconomic status, and immigration or acculturation patterns, which can shape cancer risk and outcomes.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What does the article aim to provide regarding gastrointestinal cancer?",{"text":117,"@type":113},"It presents gastrointestinal cancer incidence and mortality in AANHPI, including disaggregated rates where feasible, and highlights gaps in current screening practices.",{"name":119,"@type":110,"acceptedAnswer":120},"What challenges make disaggregated reporting of cancer statistics difficult?",{"text":121,"@type":113},"The article notes incomplete or inaccurate demographic data in registries and records, limited availability of population figures for smaller origin groups, and instability of year-to-year estimates when case counts are small.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},331611,1790072769,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},1374391974564,"https://ap-avatar.wpscdn.com/avatar/14000253aa45c000a9e?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779874745381141002","Personal View   \nShattering the monolith: burden of gastrointestinal cancer in Asian Americans, Native Hawaiians, and Pacific Islanders in the United States  \nJi Yoon Yoon,a Shailja C. Shah,b,c Jenny J. Lin,d Michelle Kang Kim,e Steven H. Itzkowitz,a and Christina P. Wanga,∗  \naDr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA bGI Section, VA San Diego Healthcare System, San Diego, CA, USA  \ncDivision of Gastroenterology, University of California San Diego, San Diego, CA, USA  \ndDivision of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA eDepartment of Gastroenterology, Hepatology and Nutrition, Cleveland Clinic, Cleveland, OH, USA  \nSummary  \nAsian Americans remain the fastest-growing racial group in the United States, and are anticipated to double over the next few decades. Asian Americans are the only major racial-ethnic group for whom cancer remains the leading cause of death, and multiple gastrointestinal cancers rank among the top five incident and fatal cancers. Most research to date presents Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) in aggregate, overlooking their vast heterogeneity and hindering efforts to identify and address health disparities within AANHPI origin groups. Here, we present gastrointestinal cancer incidence and mortality in AANHPI, including disaggregated rates where feasible, and highlight gaps in current screening practices. We conclude with actionable suggestions to shift away from using broad racial categories to evaluate cancer disparities, towards high-quality, disaggregated data to better isolate and address factors driving the clear differential cancer risks among AANHPI.  \nCopyright © 2024 The Author(s) . Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)).  \nKeywords: Asian American Native Hawaiian and Pacific Islander; Gastrointestinal neoplasms; Esophageal neoplasms; Stomach neoplasms; Liver neoplasms; Pancreatic neoplasms; Colorectal neoplasms; Health inequities; Early detection of cancer  \nThe Lancet Regional Health -Americas 2025;41: 100954  \nPublished Online 23 November 2024 [https://doi.org/10](https://doi.org/10) . 1016/j.lana.2024 . 100954  \nAsian Americans (AA) are the fastest-growing single racial or ethnic group in the United States (US), followed by Hispanic Americans, and Native Hawaiians/ Pacific Islanders,1,2 who rank second and third in population growth, respectively.3 Cancer is the leading cause of death among AA and includes potentially preventable gastrointestinal (GI) cancers,4,5 in contrast to other major race-ethnicity groups (non-Hispanic White [NHW], non-Hispanic Black [NHB], Hispanic), for whom cardiovascular disease is the leading cause of death.5  \nBroad racial categories (“AANHPI”) obscure understanding of cancer risk and disparities  \nAANHPI is a nebulous, sociological description that encompasses over 40 distinct ethnic groups (henceforth referred to as ‘origin groups’), and is defined asa “person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian  \n*Corresponding author. Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1069, New York, NY, 10029, USA.  \nE-mail address: [christina.wang@mountsinai.org](christina.wang@mountsinai.org) (C.P. Wang).  \nSubcontinent or the Pacific Islands.”6 Unfortunately, the term overlooks the vast heterogeneity across lifestyles, dietary and cultural practices, health beliefs, socioeconomic status, English proficiency, acculturation, and immigration patterns.4 Its use to categorise diverse populations and to describe cancer disparities is inherently problematic, as it inadequately captures the heterogeneity and confluence of biological, environmental, and behavioural factors that shape cance","cbCaidWvOqZrBI7U","https://ap.wps.com/l/cbCaidWvOqZrBI7U","pdf",710869,"English","# Summary\n## Rationale for disaggregation of AANHPI\n## Barriers to disaggregated reporting\n## Screening gaps and actionable recommendations","[{\"question\":\"Why does the article argue that broad AANHPI categories are insufficient for cancer research?\",\"answer\":\"Broad categories (“AANHPI”) hide major differences across origin groups in lifestyle, diet, cultural practices, health beliefs, socioeconomic status, and immigration or acculturation patterns, which can shape cancer risk and outcomes.\"},{\"question\":\"What does the article aim to provide regarding gastrointestinal cancer?\",\"answer\":\"It presents gastrointestinal cancer incidence and mortality in AANHPI, including disaggregated rates where feasible, and highlights gaps in current screening practices.\"},{\"question\":\"What challenges make disaggregated reporting of cancer statistics difficult?\",\"answer\":\"The article notes incomplete or inaccurate demographic data in registries and records, limited availability of population figures for smaller origin groups, and instability of year-to-year estimates when case counts are small.\"}]","Shattering the monolith: burden of gastrointestinal cancer in Asian Americans, Native Hawaiians, and Pacific Islanders in the United States | PDF",1789994301,25]