ASPIRE Cohort Launches as First Large-Scale Longitudinal Cancer Study Focused on Asian Americans
Key Insights
The $12.5 million NCI-funded ASPIRE Cohort will follow 20,000 Asian Americans over time, marking the first large-scale longitudinal cancer study focused on this population.
Cancer is the leading cause of death among Asian Americans, with rising rates of lung cancer (search) in nonsmoking women and early-onset breast cancer (search) before age 50.
Researchers from UCSF, UC Davis, UC Irvine, Cedars-Sinai, and Temple University aim to disaggregate data across more than 30 ethnicities to uncover hidden cancer disparities.
Cancer is now the leading cause of death among Asian Americans, yet this population remains severely understudied in U.S. cancer research. A coalition of California research institutions, led by UC San Francisco (search), has launched the ASPIRE Cohort (Asian American Cohort Study), a $12.5 million National Cancer Institute-funded initiative that will follow 20,000 Asian Americans over time — the first large-scale longitudinal cancer study focused on this diverse population.
"Asian Americans are actually the first racial and ethnic group for whom cancer is the leading cause of death," said Scarlett Gomez, a cancer epidemiologist at UCSF and a lead on the project. The study brings together researchers from UCSF, UC Irvine, UC Davis, Cedars-Sinai, and Temple University, with UC Davis Comprehensive Cancer Center (search) serving as one of 20 academic institutions nationwide helping to recruit participants.
Rising Cancer Rates Defy Conventional Explanations
Lung cancer (search) incidence has declined across much of the United States as smoking rates have fallen. However, researchers have observed a slight increase among Asian Americans, particularly among women, despite relatively low smoking rates. More than half of Asian American women diagnosed with lung cancer are nonsmokers, according to the researchers.
Many existing studies of lung cancer (search) risk among nonsmokers have been conducted in Asia, where exposure patterns can differ significantly from those in the United States, said Iona Cheng, a molecular epidemiologist at UCSF and also a lead on the project. While outdoor air pollution, secondhand smoke, and cooking oil fumes are known contributors to lung cancer risk, it remains unclear whether these factors explain disease patterns among Asian Americans living in the U.S.
Breast cancer (search) trends are also driving urgency. "Early onset breast cancer — diagnosed before age 50 — is going up the fastest among Asian Americans," Gomez said. Recent data show rates among Asian Americans, Native Hawaiians, and Pacific Islanders are approaching those of non-Hispanic white women, and cancer experts do not yet know why.
Beyond a Single Category
A central goal of the ASPIRE study is to move beyond treating Asian Americans as a monolithic group. The term encompasses people with roots in dozens of countries — from Sri Lanka to China's border with Russia to Pacific islands — with completely different exposure patterns and cuisines.
"When we separate and look at all the distinct Asian ethnicities, we see a wide variation," Cheng said. Filipino women, for instance, have a higher incidence of thyroid cancer (search), while stomach cancer (search) has been more common among some Korean and Japanese populations. Combining all Asian Americans into one category can make those differences impossible to detect.
Moon Chen, UC Davis principal investigator for ASPIRE, noted additional concerning patterns. "We also know that certain subgroups of Asian Americans have higher risks of certain cancers such as cancers of infectious origins, which may explain why there are higher rates of gastric, liver and cervical cancers," Chen said. "There's another concerning new trend showing increasing rates of breast cancer (search) among Asian American women younger than 50."
Study Design and Community Engagement
The ASPIRE study will examine whether factors such as stress, environmental exposures, and access to care may be impacting cancer risk. Eligible participants must be Asian or Asian American, aged 40 to 75, currently living in the United States or a U.S. territory, and never diagnosed with cancer. Participants will receive $25 for completing four surveys over 12 months.
UC Davis launched its local recruitment campaign targeting Vietnamese and Hmong communities in February at the Lunar New Year Tết Festival at Elk Grove Park and in May at the Sacramento Iu Mien 50th Anniversary celebration. ASPIRE outreach staff will approach potential participants at gathering places such as coffee shops, grocery stores, and independent living units in the Sacramento area. The Hmong Cultural Center of Butte County in Oroville will lead outreach to Hmong residents, who are more likely to live in rural areas and work in agriculture.
Addressing a Research Funding Gap
Although Asian Americans make up nearly 8% of the U.S. population, they have historically received little research funding. Existing cancer studies have often included too few Asian Americans to draw meaningful conclusions about specific ethnic groups. Salma Shariff-Marco, a social and behavioral scientist at UCSF and also a lead on the project, said this has made it hard to demonstrate the need for more targeted research. The ASPIRE cohort is designed to show variation by including a broader range of ethnic groups and more contemporary exposures than previous work.
By assembling the most comprehensive dataset ever collected on Asian American cancer risk, ASPIRE intends to deliver insights that could reshape national cancer prevention strategies, improve screening guidelines, and inform culturally relevant public health interventions.