University of Hawaiʻi at Mānoa medical student, Ryan Hiroshi “Keliʻi” Shontell, is highlighting the significance of breaking down Native Hawaiian Pacific Islander (NHPI) data to address health disparities, particularly cancer, more effectively.
Shontell, who earned his PhD in cell and molecular biology in 2023 and is currently pursuing his MD at the John A. Burns School of Medicine, is driven by his personal experience of witnessing his family members suffer from cancer.
“My father, my grandmother, great grandfather, grandfather—there’s tons, tons of cancer on my Hawaiian side,” said Shontell, who noticed a stark contrast in his family’s health compared to his Japanese side. “There’s just so little data available to improve outcomes. It’s one of my biggest goals—to fill these gaps so others don’t have to go through these family hardships with cancer.”
NHPI health data bundled with Asians
Shontell points out that, while NHPI has been a federally recognized racial category since 1997, health data for this group often remains bundled with Asians, masking significant disparities.
“It assumes Native Hawaiians are doing fine, but if you look at data from the UH Cancer Center and the Hawaiʻi Tumor Registry—that’s not the case. Native Hawaiians across the board have dismal outcomes for cancer,” he explained, referencing the disconnect between the local research focused on NHPI health outcomes when other groups used NHPI-Asian aggregated data.
Combating Indigenous community invisibility
Under the mentorship of Kekoa Taparra, Shontell joined a collaborative team of researchers from across the country that make up the Taparra Lab. The lab’s mission is to combat the invisibility of Indigenous communities by emphasizing the existence of NHPI populations in scientific research and health data collection.
It’s one of my biggest goals—to fill these gaps so others don’t have to go through these family hardships with cancer.
—Ryan Shontell
Taparra Lab researchers, including Shontell, published a study in the Journal of American Medical Association that is the first to disaggregate cancer data for NHPI adolescents and young adults (15–39 years old). The study found that NHPI patients face higher risks of late-stage cancer diagnosis and poorer survival rates from cancer overall, particularly for cancers like cervical, colorectal, lymphoma and melanoma, compared to other racial groups.
He highlights a study from the Taparra Lab that found melanoma mortality rates in NHPI are nearly 40% higher than in Caucasians. This disparity was hidden when NHPI data was lumped with Asian-Americans, who generally have better health outcomes.
“These patients aren’t being diagnosed at later stages, but they still have really dismal survival rates, so that needs to be investigated, whether it’s advocating for more directed intervention, more funding to public health programs or more funding for screening programs to be able to decrease that gap in survival between Native Hawaiian Pacific Islander patients and white patients,” Shontell said.
