Native Hawaiians tend to be diagnosed with cancer at younger ages than their Caucasian counterparts. For example,

  • more Native Hawaiian women (54%) had their breast cancer diagnosed at age less than 60 years compared to 49% of all Caucasian women with breast cancer (Braun, Fong, Gotay, & Chong, 2004).
  • Native Hawaiian patients with bladder cancer were also detected at younger ages according to a 2003 study in which 30.7% of Native Hawaiians were diagnosed prior to age 60 years old compared to 21.9% of Caucasians (Hashibe, Gao, Li, Dalbagni, & Zhang, 2003).
  • Elderly Asian or Pacific Islander women were found to have nearly double the incidence rate for invasive cervical cancer compared to Caucasian women (21.8 per 100,000 versus 12.6 per 100,000) (Saraiya et al., 2007).
  • Finally, female Native Hawaiian elders (age = 60 years) have also been reported to have up to 20% lower five-year breast cancer survival compared to the group with the highest proportion of survivors, Japanese women (Braun et al., 2004).

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»Table 1: Cancer Prevalence by Type and Geographic Location for all other Pacific Islanders

A summary of cancer prevalence by cancer site and geographic location for all other Pacific Islanders is shown in the Table 1. Of the twelve different cancer sites listed, the Marshall Islands reported the highest prevalence of cancer for four sites: breast, cervix, other/GU, and thyroid.

It is possible that the higher prevalence of cancer cases in the Marshall Islands may be due to the US nuclear testing program (1946-1958) that led to widespread radiation exposure among Marshall Island residents. The most serious exposure was a consequence of the hydrogen-thermonuclear bomb test, Castle BRAVO, which resulted in higher cancer risk among Marshall Island residents, particularly for thyroid cancer. Surviving Marshallese residents of this nuclear testing program are currently elderly and increased risk of thyroid and potentially other types of cancer remains a significant consideration for this sector of the population (Howard, Vaswani, & Heotis, 1997; Takahashi et al., 2003).

Patterns of cancer occurrence may also differ between racial groups residing in the Pacific region (Mishra, Luce-Aoelua, & Wilkens, 1996). American Samoan males residing in Hawaii have a relatively higher frequency of lung, prostate, thyroid, and liver cancers and a lower frequency of colon and rectum cancers compared to other Polynesians such as Western Samoans and Native Hawaiians. Relative to other Polynesians, American Samoan women have a higher frequency of leukemia and corpus uteri, thyroid, and pancreatic cancers, although, like their male counterparts, they have a lower frequency of colon and rectum cancers.



  • Few studies are available on patterns of cancer occurrence among elderly Native Hawaiians and Pacific Islanders.
  • In general, Native Hawaiians tend to be diagnosed at a younger age and experience lower survival rates compared to other racial groups.
  • Among other Pacific Islanders, Marshallese have the highest prevalence of breast, cervical, other/GU and thyroid cancers compared to other Pacific Islanders which may be due to effects of US nuclear testing in the region during the 1950s.