Advanced Breast Cancer Risk in Asian American, Native Hawaiian, and Pacific Islanders

The long-term goal of the Hawaiʻi Pacific Islands Mammography Registry (HIPIMR) is to develop accurate and validated models of breast cancer risk and detection in real-time for women with the diverse breast cancer risk profiles as described above who have not been well represented in breast cancer cohorts and clinical trials so far.


Below you will find studies put on by the UH Cancer Center in collaboration with various research institutions and medical partners to address this issue, with a special focus on the unique population of Hawaiʻi and the Pacific.

Breast Cancer Risk Assessment in Hawaiʻi and the USAPI

This pilot study will use breast cancer screening in Hawaiʻi and Guam to identify trends of breast cancer risk in Asian American, Native Hawaiian, and Pacific Islander groups. Our central hypothesis is that the prevalence and importance of breast cancer risk factors and image factors are different in the diverse populations found in Hawaii and the USAPI and by identifying these factors, more accurate screening models can be developed.

A map showing the Pacific Ocean with pins on Guam and Hawai'i. Guam includes a zoomed in circle with pins on University of Guam and Guam Radiology Consultants. Hawai'i includes a zoomed circle with a pin on University of Hawai'i Cancer Center..

Breast Health Questionnaire Standardization

We propose a project for a breast health questionnaire standardized for use across the state of Hawaiʻi. Currently, the breast health information being collected at mammography clinics varies across the state. In many cases, it is inadequate to determine a woman’s risk of developing breast cancer in the future. Using the same questions and information across the state for all women allows for researchers and doctors to calculate breast cancer risk in the same way using the most up-to-date models.

The Makawalu Study: Breast Cancer Screening in the Pacific using Portable Ultrasound

Advanced stage breast cancer (Stage III/IV) rates in the Pacific are much higher than in the US mainland, especially where mammography services do not exist or have low accessibility. Furthermore, Hawaiʻi and Guam both have high insurance coverage and mammography access similar to the US mainland, so why does this problem still exist? In this study, we aim to identify cofactors (breast density, ethnicity, BMI, etc.) that impact the sensitivity and specificity for malignant breast cancer lesion detection on clinical ultrasound images with AI support for readers of varying backgrounds and experience and in areas where mammography is not available.

Completed Projects

The Accessible Breast Cancer Screening in the Pacific Study

In this pre-pilot study, we propose to evaluate the effectiveness of the iBreastExam (iBE) as an early detection tool among women of Pacific Islander ancestry. We would also test the acceptance of the technology with an interview of the participants. With the completion of this pilot, we would gain a preliminary understanding of the strengths and limitations of this device and the acceptance of the device in the community.