RESUMEN
The Hispanic/Latino population is the second largest racial/ethnic group in the continental United States and Hawaii, accounting for 18% (60.6 million) of the total population. An additional 3 million Hispanic Americans live in Puerto Rico. Every 3 years, the American Cancer Society reports on cancer occurrence, risk factors, and screening for Hispanic individuals in the United States using the most recent population-based data. An estimated 176,600 new cancer cases and 46,500 cancer deaths will occur among Hispanic individuals in the continental United States and Hawaii in 2021. Compared to non-Hispanic Whites (NHWs), Hispanic men and women had 25%-30% lower incidence (2014-2018) and mortality (2015-2019) rates for all cancers combined and lower rates for the most common cancers, although this gap is diminishing. For example, the colorectal cancer (CRC) incidence rate ratio for Hispanic compared with NHW individuals narrowed from 0.75 (95% CI, 0.73-0.78) in 1995 to 0.91 (95% CI, 0.89-0.93) in 2018, reflecting delayed declines in CRC rates among Hispanic individuals in part because of slower uptake of screening. In contrast, Hispanic individuals have higher rates of infection-related cancers, including approximately two-fold higher incidence of liver and stomach cancer. Cervical cancer incidence is 32% higher among Hispanic women in the continental US and Hawaii and 78% higher among women in Puerto Rico compared to NHW women, yet is largely preventable through screening. Less access to care may be similarly reflected in the low prevalence of localized-stage breast cancer among Hispanic women, 59% versus 67% among NHW women. Evidence-based strategies for decreasing the cancer burden among the Hispanic population include the use of culturally appropriate lay health advisors and patient navigators and targeted, community-based intervention programs to facilitate access to screening and promote healthy behaviors. In addition, the impact of the COVID-19 pandemic on cancer trends and disparities in the Hispanic population should be closely monitored.
Asunto(s)
Detección Precoz del Cáncer/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Hispánicos o Latinos/estadística & datos numéricos , Neoplasias/etnología , Adolescente , Adulto , Anciano , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Neoplasias/prevención & control , Puerto Rico/epidemiología , Factores de Riesgo , Tasa de Supervivencia , Estados Unidos/epidemiología , Población Blanca/estadística & datos numéricos , Adulto JovenRESUMEN
Cancer is the leading cause of death among Hispanics/Latinos, who represent the largest racial/ethnic minority group in the United States, accounting for 17.8% (57.5 million) of the total population in the continental United States and Hawaii in 2016. In addition, more than 3 million Hispanic Americans live in the US territory of Puerto Rico. Every 3 years, the American Cancer Society reports on cancer occurrence, risk factors, and screening for Hispanics in the United States based on data from the National Cancer Institute, the North American Association of Central Cancer Registries, and the Centers for Disease Control and Prevention. For the first time, contemporary incidence and mortality rates for Puerto Rico, which has a 99% Hispanic population, are also presented. An estimated 149,100 new cancer cases and 42,700 cancer deaths will occur among Hispanics in the continental United States and Hawaii in 2018. For all cancers combined, Hispanics have 25% lower incidence and 30% lower mortality compared with non-Hispanic whites, although rates of infection-related cancers, such as liver, are up to twice as high in Hispanics. However, these aggregated data mask substantial heterogeneity within the Hispanic population because of variable cancer risk, as exemplified by the substantial differences in the cancer burden between island Puerto Ricans and other US Hispanics. For example, during 2011 to 2015, prostate cancer incidence rates in Puerto Rico (146.6 per 100,000) were 60% higher than those in other US Hispanics combined (91.6 per 100,000) and 44% higher than those in non-Hispanic whites (101.7 per 100,000). Prostate cancer is also the leading cause of cancer death among men in Puerto Rico, accounting for nearly 1 in 6 cancer deaths during 2011-2015, whereas lung cancer is the leading cause of cancer death among other US Hispanic men combined. Variations in cancer risk are driven by differences in exposure to cancer-causing infectious agents and behavioral risk factors as well as the prevalence of screening. Strategies for reducing cancer risk in Hispanic populations include targeted, culturally appropriate interventions for increasing the uptake of preventive services and reducing cancer risk factor prevalence, as well as additional funding for Puerto Rico-specific and subgroup-specific cancer research and surveillance.
Asunto(s)
Disparidades en el Estado de Salud , Hispánicos o Latinos/estadística & datos numéricos , Neoplasias/epidemiología , Programa de VERF/estadística & datos numéricos , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Prevalencia , Puerto Rico/epidemiología , Factores de Riesgo , Tasa de Supervivencia , Estados Unidos/epidemiología , Población Blanca/estadística & datos numéricosRESUMEN
Background: Cancer is the leading cause of death among Hispanics. The burden of cancer mortality within Hispanic groups has not been well quantified.Methods: Cancer mortality rates for 2008-2012 in Florida were computed on the basis of race, ethnicity, and birthplace, specifically focusing on major Hispanic groups-Mexicans, Puerto Ricans, Cubans, Central Americans, South Americans, and Dominicans. Age-adjusted mortality rate ratios derived from negative binomial regression were used to compare Hispanics, aggregated and by group, to nonHispanic whites (NHW).Results: A total of 205,369 cancer deaths from 2008-2012 were analyzed, of which 22,042 occurred in Hispanics. Overall cancer mortality rates were lower for Hispanics, 159 and 100 per 100,000 in males and females, respectively, compared with 204 and 145 per 100,000 in NHWs, largely driven by relatively low rates of lung and breast cancers among Hispanics. However, Hispanics had a higher risk of death from stomach and liver cancers, both infection-related. Of all Hispanic groups, Mexicans had the lowest mortality, whereas Cubans had the highest, with significantly higher mortality for colorectal, endometrial, and prostate cancers.Conclusions: Compared with other Hispanic groups, Cubans and Puerto Ricans had significantly higher rates. For these longer-established populations in the United States, increases in diet and obesity-related cancers are evident. Some groups show excesses that clearly fall out of the common Hispanic patterns, with implications for public health: Cubans for colorectal cancer, Puerto Ricans for liver cancer, and Dominicans for prostate cancer.Impact: Cancer mortality outcomes in Hispanics vary between ethnic groups. Research and public health strategies should consider this heterogeneity. Cancer Epidemiol Biomarkers Prev; 26(3); 376-82. ©2017 AACR.