Cancer now leading cause of death in U.S. Hispanics

The report, "Cancer Facts & Figures for Hispanics/Latinos 2012-2014," and an accompanying journal article in CA: A Cancer Journal for Clinicians were released September 17.

Hispanics are the largest and fastest-growing minority group in the US, accounting for 16.3% of the population in 2010. The report estimates that in 2012, 112,800 new cases of cancer will be diagnosed and 33,200 cancer deaths will occur among Hispanics.

Even though cancer is the leading cause of death in US Hispanics, the rates of new cancer diagnoses and cancer deaths among this group have been declining in recent years, and have been declining faster than among other segments of the population. During the last 10 years of available data, 2000-2009, rates of new cancer diagnoses declined by 1.7% per year among men and 0.3% per year among women. That compares to declines of 1.0% among non-Hispanic white men and 0.2% among non-Hispanic white women. Cancer death rates among Hispanics declined by 2.3% per year in men and 1.4% per year in women during that same time period, compared with declines of 1.5% among non-Hispanic white men and 1.3% among non-Hispanic white women.

Hispanics have lower rates of new cases and deaths than non-Hispanic whites for all cancers combined and for the 4 most common cancers -- breast, prostate, lung, and colon. For example, lung cancer rates among Hispanics are about half those of non-Hispanic whites, largely because they have historically been less likely to smoke cigarettes than non-Hispanic whites, according to the report.

However, Hispanics have higher rates of new cases and deaths for cancers of the stomach, liver, cervix, and gallbladder, reflecting greater exposure to cancer-causing infectious agents, lower rates of screening for cervical cancer, and possibly genetic factors. Rates of new cases and deaths for cervical cancer are 50% to 70% higher in Hispanic women compared to non-Hispanic whites. In addition, Hispanics are more likely than non-Hispanic whites to be diagnosed at an advanced stage of disease for most cancer types.

Much of the difference in the cancer burden among US Hispanics results from their unique profile in terms of age distribution, socio-economic status, and immigration history. Just 1 in 10 US Hispanics is 55 years or older, the age group among whom the majority of cancers are diagnosed, compared with almost 1 in 3 non-Hispanics. In 2010, more than 1 in 4 (26.6%) Hispanics lived in poverty and nearly 1 in 3 (30.7%) was uninsured. For non-Hispanic whites, 9.9% lived in poverty and 11.7% were uninsured.

Hispanics in the US are an extremely diverse group because they originate from many different countries. As a result, cancer patterns among Hispanic sub-populations vary substantially. For example, in Florida the cancer death rate among Cuban-American men is double that of Mexican-American men. The report provides information about major cancer-related risk factors within the Hispanic population by country of origin. For example, Cuban-American men are much more likely to smoke than Dominican-American men. Dominican men are also much less likely to be obese than Mexican-American or Puerto Rican men.

There are also differences between Hispanic subgroups in screening behavior. Mexican-American women are less likely to have had a recent mammogram than Dominican-American women. Strategies for reducing cancer risk among Hispanics include improving access to screenings and vaccinations, as well as employing strategies to reduce tobacco use, obesity, and alcohol consumption.

Rebecca Siegel, MPH, lead author of the report said, "There is substantial heterogeneity within the US Hispanic population. The most effective strategies for reducing the cancer burden in these underserved communities utilize tailored, culturally appropriate interventions, such as patient navigation, to increase access to medical services."