RESUMEN

BACKGROUND: The diversity among Hispanics/Latinos, defined by geographic origin (e.g., Mexico, Puerto Rico, Cuba), has been neglected when assessing cancer morbidity. For the first time in the United States, we estimated cancer rates for Cubans, Mexicans, Puerto Ricans, and other Latinos, and analyzed changes in cancer risk between Hispanics in their countries of origin, U.S. Hispanics in Florida, and non-Hispanic Whites in Florida. METHODS: Florida cancer registry (1999-2001) and the 2000 U.S. Census population data were used. The Hispanic Origin Identification Algorithm was applied to establish Hispanic ethnicity and subpopulation. RESULTS: The cancer rate of 537/100,000 person-years (95% confidence interval, 522.5-552.5) for Hispanic males in Florida was lower than Whites (601; 595.4-606.9). Among women, these rates were 376 (365.6-387.1) and 460 (455.6-465.4), respectively. Among Florida Hispanics, Puerto Ricans had the highest rates, followed by Cubans. Mexicans had the lowest rates. Rates for Hispanics in Florida were at least 40% higher than Hispanics in their countries of origin, as reported by the IARC. CONCLUSION: Substantial variability in cancer rates occurs among Hispanic subpopulations. Cubans, unlike other Hispanics, were comparable with Whites, especially for low rates of cervical and stomach cancers. Despite being overwhelmingly first generation in the U.S. mainland, Puerto Ricans and Cubans in Florida showed rates of colorectal, endometrial, and prostate cancers similar to Whites in Florida. Because rates are markedly lower in their countries of origin, the increased risk for cancer among Cubans, Mexicans, and Puerto Ricans who move to the United States should be further studied.

Asunto(s)

RESUMEN

OBJETIVO: Comparar de manera directa la incidencia de cáncer en niños hispanos y en niños blancos no hispanos en los estados de California y la Florida, donde viven casi las dos terceras partes de toda la población infantil hispana de Estados Unidos de América. MÉTODOS: Del Sistema de Estadísticas de Cáncer de la Florida (Florida Cancer Data System) y del Registro de Cáncer de California (California Cancer Registry) se sacaron datos transversales de 1988 a 1998 correspondientes a todos los casos nuevos de cáncer en niños (<15 años de edad), codificados según raza u origen étnico en "hispanos" o "blancos no hispanos". Los resultados se expresaron en forma de tasas de incidencia estandarizadas por edad, usando como referencia la población mundial estándar en millones de habitantes. Se comparó la frecuencia de cáncer en niños hispanos y en niños blancos no hispanos mediante razones de incidencia estandarizadas (RIE) y sus respectivos intervalos de confianza del 95% (IC95%). RESULTADOS: Al compararse la frecuencia de todos los tipos de cáncer en niños hispanos y niños blancos no hispanos, la RIE fue de 1,02 (IC95%: 0,99 a 1,05). Al examinarse ciertos tipos de tumores en particular, las RIE apuntaron a mayores tasas de incidencia de leucemia (RIE = 1,26; IC95%: 1,19 a 1,34), linfoma de Hodgkin (RIE = 1,29; IC95%: 1,08 a 1,54), y tumores de células germinativas (RIE = 1,62; IC95%: 1,34 a 1,96) en niños hispanos. Estos últimos tuvieron menores incidencias de tumores del sistema nervioso central (RIE = 0,72; IC95%: 0,66 a 0,78) y de tumores del sistema nervioso simpático (RIE = 0,76; IC95%: 0,66 a 0,87). En lo que respecta a diferencias entre estados, la incidencia de linfoma, de tumores del sistema nervioso central, de tumores del sistema nervioso simpático y de tumores óseos malignos fue mayor entre jóvenes hispanos residentes de la Florida; en cambio, la incidencia de hepatomas malignos fue mayor entre jóvenes hispanos residentes de California. CONCLUSIONES: Aunque la incidencia general de cáncer en niños hispanos fue semejante a la observada en niños blancos no hispanos, se hallaron diferencias significativas en el caso de ciertos tumores en particular. Habida cuenta de que ser hispano puede ser un factor de confusión en relación con otros factores de riesgo de cáncer (familiares, socioeconómicos o ambientales), se recomienda explorar estos últimos factores en futuras investigaciones sobre el riesgo de cáncer en niños hispanos.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

We need to critically assess the present quality of the marine ecosystem, especially the connection between ecosystem change and threats to human health. In this article we review the current state of indicators to link changes in marine organisms with eventual effects to human health, identify research opportunities in the use of indicators of ocean and human health, and discuss how to establish collaborations between national and international governmental and private sector groups. We present a synthesis of the present state of understanding of the connection between ocean health and human health, a discussion of areas where resources are required, and a discussion of critical research needs and a template for future work in this field. To understand fully the interactions between ocean health and human health, programs should be organized around a "models-based" approach focusing on critical themes and attributes of marine environmental and public health risks. Given the extent and complex nature of ocean and human health issues, a program networking across geographic and disciplinary boundaries is essential. The overall goal of this approach would be the early detection of potential marine-based contaminants, the protection of marine ecosystems, the prevention of associated human illness, and by implication, the development of products to enhance human well-being. The tight connection between research and monitoring is essential to develop such an indicator-based effort.

Asunto(s)