Construction of the Armenian Surname List (ASL) for public health research.

BACKGROUND: There are an estimated 460,000 Armenians in the United States, and more than half live in California. Armenian-Americans are generally represented within the 'White' or 'Some Other Race' race categories in population-based research studies. While Armenians have been included in studies focused on Middle-Eastern populations, there are no studies focused exclusively on Armenians due to a lack of standardized collection of Armenian ethnicity in the United States or an Armenian surname list. To fill this research gap, we sought to construct and evaluate an Armenian Surname List (ASL) for use as an identification tool in public health and epidemiological research studies focused on Armenian populations. METHODS: Data sources for the ASL included the California Public Use Death Files (CPUDF) and the Middle Eastern Surname List (MESL). For evaluation of the ASL, the California Cancer Registry (CCR) database was queried for surnames with birthplace in Armenia and identified by the MESL. RESULTS: There are a total of 3,428 surnames in the ASL. Nearly half (1,678) of surnames in the ASL were not identified by the MESL. The ASL captured 310 additional Armenian surnames in the CCR than the MESL. CONCLUSIONS: The ASL is the first surname list for identifying Armenians in major databases for epidemiological research.

Evaluation of Cancer Deaths Attributable to Tobacco in California, 2014-2019.

Importance: California's tobacco control efforts have been associated with a decrease in cancer mortality, but these estimates are based on smoking prevalence of the general population. Patient-level tobacco use information allows for more precise estimates of the proportion of cancer deaths attributable to smoking. Objective: To calculate the proportion (smoking-attributable fraction) and number (smoking-attributable cancer mortality) of cancer deaths attributable to tobacco use using patient-level data. Design, Setting, and Participants: The smoking-attributable fraction and smoking-attributable cancer mortality were calculated for a retrospective cohort of patients whose cancer was diagnosed from 2014 to 2019 with at least 1 year of follow-up using relative risks from large US prospective studies and patient-level smoking information. Follow-up continued through April 2022. A population-based cohort was identified from the California Cancer Registry. Participants included adults aged 20 years and older with a diagnosis of 1 of the 12 tobacco-related cancers (oral cavity or pharynx, larynx, esophagus, lung, liver, stomach, pancreas, kidney, bladder, colon or rectum, cervix, and acute myeloid leukemia). Exposures: Tobacco use defined as current, former, or never. Main Outcomes and Measures: The primary outcomes were the smoking-attributable fraction and smoking-attributable cancer mortality for each of the 12 tobacco-related cancers over 2 time periods (2014-2016 vs 2017-2019) and by sex. Results: Among 395 459 patients with a tobacco-related cancer, most (285 768 patients [72.3%]) were older than 60 years, the majority (228 054 patients [57.7%]) were non-Hispanic White, 229 188 patients were men (58.0%), and nearly one-half (184 415 patients [46.6%]) had lung or colorectal cancers. Nearly one-half of the deaths (93 764 patients [45.8%]) in the cohort were attributable to tobacco. More than one-half (227 660 patients [57.6%]) of patients had ever used tobacco, and 69 103 patients (17.5%) were current tobacco users, which was higher than the proportion in the general population (11.7%). The overall smoking-attributable fraction of cancer deaths decreased significantly from 47.7% (95% CI, 47.3%-48.0%) in 2014 to 2016 to 44.8% (95% CI, 44.5%-45.1%) in 2017 to 2019, and this decrease was seen for both men and women. The overall smoking-attributable cancer mortality decreased by 10.2%. Conclusions and Relevance: California still has a substantial burden of tobacco use and associated cancer. The proportion of cancer deaths associated with tobacco use was almost double what was previously estimated. There was a modest but significant decline in this proportion for overall tobacco-associated cancers, especially for women.

Increasing Rates of Colorectal Cancer Among Young People in California, 1988-2017.

Background: Colorectal cancer (CRC) incidence among persons older than 50 years has decreased in California and nationally, but incidence rates have increased among persons younger than 50 years. Previous studies present incidence rates among younger persons using a wide age group of 20-49 years. However, previous population-based studies did not analyze CRC incidence in subgroups defined by age, sex, race/ethnicity, and stage at diagnosis to better understand incidence trends among younger persons. Methods/Approach: We identified all people diagnosed with CRC at the age of 20-49 years from the California Cancer Registry (n = 39,298; 1988-2017). We used SEER*Stat and Joinpoint software to calculate average annual percentage changes (AAPCs) in incidence rates by age at diagnosis, sex, race/ethnicity, and stage. Age was divided into 10-year intervals (20-29, 30-39, and 40-49 years), stage was categorized as early- and late-stage, and race/ethnicity as non-Hispanic White, non-Hispanic Black, Hispanic, Asian/Pacific Islander, and American Indian groups. Results: Statistically significant increases in early-stage CRC incidence rates were observed among the 20-29, 30-39, and 40-49-year age groups in male and female non-Hispanic White populations (AAPC, 6.3%, 3.3%, and 1.9%, respectively) and Hispanic populations (AAPC, 4.9%, 3.5%, and 2.3%, respectively). Statistically significant increases in late-stage CRC incidence rates were observed among all 3 age groups of male and female non-Hispanic White people (AAPC, 2.8%, 3.1%, and 1.7%, respectively) and Hispanic females (AAPC, 4.2%, 2.3%, and 1.1%, respectively). Statistically significant increases in late-stage CRC incidence rates were also seen in the 30-39 and 40-49-year age groups among non-Hispanic White females (AAPC, 3.4% and 1.8%, respectively), Hispanic males (AAPC, 3.6% and 1.6%, respectively), and Asian/Pacific Islander females (AAPC, 1.9% and 0.7%, respectively). Statistically significant increases in late-stage CRC incidence were observed among 40-to 49-year-old Asian/Pacific Islander males (AAPC, 1.4%) and American Indian males and females (AAPC, 5.5%). Conclusion: CRC is increasing among several young age groups. Because evidence suggests that younger adults present with more advanced disease, these results may be useful for educating health care providers about CRC risk and suggest that CRC screening recommendations should be developed for this population. Continued surveillance of CRC incidence rates among young adults is warranted.