While cancer is the second leading cause of death overall in the United States, it remains the leading cause of death among U.S. Hispanics, according to the new edition of the American Cancer Society's “Cancer Statistics for Hispanics/Latinos” (CA Cancer J Clin 2015: doi: 10.3322/caac.21314).
As noted in a news release, Hispanics/Latinos represent the largest racial/ethnic minority group in the United States, accounting for about 17 percent pf the total U.S. population. This year, an estimated 125,900 new cancer cases and 37,800 cancer deaths are expected among U.S. Hispanics/Latinos.
The report showed that lung cancer remains the leading cause of cancer death for Hispanic men, accounting for about one in six cancer deaths (17%). Based on the 2015 estimates, liver cancer is projected to surpass colorectal cancer as the second leading cause of cancer deaths among Hispanic men. Liver cancer incidence and death rates in Hispanic men and women are about double those in non-Hispanic whites.
Among Hispanic women, the leading cause of cancer death is breast cancer (16%), followed by lung and colorectal cancers. Lung cancer surpassed breast cancer as the leading cause of death among women overall in the U.S. in 1987.
Lung cancer death rates in Hispanic women are 70 percent lower than those in non-Hispanic white women because of historically low smoking prevalence in Hispanic women, the report noted. In 2014, eight percent of Hispanic women smoked cigarettes compared with 17 percent of non-Hispanic white women.
Cancer death rates have been decreasing since 1995 in Hispanic men and since 1996 in Hispanic women—four years later than declines began in non-Hispanic whites. Cancer incidence rates among Hispanics/Latinos are dropping 2.4 percent a year in men and 0.5 percent a year in women, mirroring trends among non-Hispanic whites.
Higher Risk of Cancers Related to Infectious Agents
Overall, cancer incidence rates are 20 percent lower in Hispanics than in non-Hispanic whites, and cancer mortality rates are 30 percent lower. This is mainly because, the report explains, Hispanics are less likely than non-Hispanic whites to be diagnosed with the four most common cancers (prostate, breast, lung, and colon).
Hispanics do, however, have a higher risk of cancers associated with infectious agents, such as those of the stomach, liver, and cervix. For example, stomach and liver cancer incidence and death rates in Hispanics are double those in non-Hispanic whites.
Countries of Origin
The cancer profile of Hispanics/Latinos living in the U.S. is strikingly different from that for non-Hispanic whites and reflects the risk in countries of origin, particularly for more recent immigrants, the report explains. For example, overall, death and incidence rates in Puerto Ricans and Cubans are more similar to those in non-Hispanic whites than in those of Mexican origin, who immigrated to the U.S. in large numbers more recently.
Hispanics are particularly vulnerable to cancer inequalities, the authors noted. Hispanics are generally less likely than non-Hispanic whites to be diagnosed at an early stage, especially for melanoma and female breast cancer. Although less access to high-quality care due to lower socioeconomic status contributes to this disparity, some studies have shown that Hispanics are at higher risk of advanced-stage disease even when socioeconomic status and health care access are similar.
‘Driven Primarily by Births, Not Immigration’
“The growth in the population of U.S. residents of Hispanic origin is now driven primarily by births, not immigration, which will probably change the future cancer risk profile of this group” said the report's lead author, Rebecca L. Siegel, MPH, the ACS's Director of Surveillance Information. “The second generation, born and raised in the U.S. and more intertwined in our lifestyle, including our diet, has higher cancer rates than first-generation immigrants, so we may see a higher cancer burden in this group in the future.”
She and her coauthors recommend the use of culturally appropriate lay health advisors and patient navigators; targeted, community-based intervention programs to increase screening and vaccination and encourage healthy lifestyle behaviors; and further funding for research into cancer risk and prevention among specific subgroups in this population.
The other coauthors of the report are Stacey A. Fedewa, MPH; Kimberly D. Miller, MPH; Ann Goding-Sauer, MPH; and Ahmedin Jemal, DVM, PhD, of the ACS; Paulo S. Pinheiro, MD, PhD, of the University of Nevada; and Dinorah Martinez-Tyson, PhD, MPH, MA, of the University of South Florida.