A Case for Race Disaggregation

We have been working closely with the Arizona Cancer Registry of the Arizona Department of Health Services (ADHS) for the past two years. The result is a brief report entitled “Cancer Cases by AAPI Race Distribution 1995 – 2007” that examines cancer reporting by ethnic subgroup of Asian Americans and Pacific Islanders in Arizona. The report makes a case that reporting of specific AAPI subgroups can help with cancer control efforts. Here’s a directive from ADHS that will be released in conjunction with the report:

The Arizona Department of Health Services (ADHS) reminds physicians to list the specific race of patients when sending disease reports to the Department. Race-specific information is important for planning and delivering effective public health programs. It also can be helpful at the clinical level. For example, persons born in Korea or China have an elevated risk for cervical cancer, and rates of stomach cancer are elevated in China and Japan. Unfortunately, the use of the generic term “Asian” without further specification has increased from 35% in 1995 to 50% in 2007. The Arizona Cancer Registry is partnering with the Asian Pacific Community in Action to promote the collection of demographic data regarding patient race, Hispanic ethnicity, tribal affiliation, and place of birth. When these factors are framed as clinically important, patients are unlikely to perceive the questions as intrusive. Including these data elements in the patient registration form or physician notes will greatly facilitate the accurate classification of patient race.

As a colleague once stated, there is a lot of suffering hidden by the aggregation of the many AAPI ethnicities and nationalities into a monolithic category of “Asian/Pacific Islander”. We strongly support disease reporting by the racial/ethnic categories as outlined in guidelines developed by the federal Office of Management and Budget.

We thank the Arizona Cancer Registry, and Dr. Tim Flood and Ms. Lana Khatib specifically, for their generous assistance in developing and disseminating this report.

- Doug Hirano, MPH, APCA Executive Director