Cancer for « Hispanics » in USA

Sources : American Cancer Society

Introduction

According to the US Census Bureau, 50.5 millions Americans, or 16% of the total US population, identified themselves as Hispanic or Latino in 2010. The terms « Hispanic » and « Latino/a » are used to refer to persons of Hispanic origin.
The word Hispanic is a US federal designation used in national and state reporting systems that is a separate concept from race; therefore, persons of Hispanic origin may be of any race. Latino/a is a self-designated term of ethnicity. In this document, Hispanic and Latino/a are used interchangeably without preference or prejudice. Hispanics are the largest, fastest-growing, and youngest minority group in the United States.

Between 2000 and 2010 the Hispanic population grew by 43%, four times the growth of the total population.
In 2010, 30% of Hispanics in the US were younger than 15 years, compared to 19% of non-Hispanics.

Approximately 37% of Hispanics are born outside the US. The majority of Hispanics are of Mexican origin (63%), followed by Puerto Rican (9%), Central American (8%), South American (6%), and Cuban (4%) and other descent. The Hispanic population is not equally distributed across the US, but is concentrated in the West (41%) and South (36%). More than half of all Hispanics live in California (28%) Texas (19%), or Florida (8%). Among states there is substantial variation in the Hispanic population by country of origin. For example, Mexican Americans comprise more than 80% of the Hispanic population in both Texas and California, compared to only 15% in Florida. This report presents statistics on cancer incidence, mortality, survival, and risk factors for Hispanics in the US. All incidence and mortality rates have been age adjusted to the standard US population of the 2000 census in order to allow comparison between population groups with different age distributions.

This publication is intended to provide information to community leaders, public health and health care workers, and others interested in cancer prevention, early detection, and treatment for Hispanics.

It is important to note that most cancer data in the US are reported for Hispanics as an aggregate group, which masks important differences that exist between Hispanic subpopulations according to country of origin. For example, a study of Hispanic adults in Florida found that the age-adjusted cancer death rate in Cuban men (327.5 per 100,000) was twice that in Mexican men (163.4 per 100,000).

What Is Cancer?

Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. If the spread is not controlled, it can result in death. Cancer is caused by both external factors (tobacco, infectious organisms, poor nutrition, chemicals,and radiation) and internal factors (inherited mutations, hormones, immune conditions, and mutations that occur from metabolism). These causal factors may act together or in sequence to initiate or promote cancer development. Cancers associated with infectious agents are much more common among Hispanics than non-Hispanics; one in six new cancers in Latin America, compared to one in 25 new cancers in North America, is attributable to infectious agents.4 Ten or more years often pass between exposure to external factors and detectable cancer. Cancer is treated with surgery, radiation, chemotherapy, hormone therapy, biologic therapy, and targeted therapy.

Can Cancer Be Prevented?

A large number of cancer cases and deaths could be prevented with the adoption of healthier lifestyles, including not smoking, maintaining a healthy body weight, and being physically active.
All cancers caused by tobacco and heavy alcohol use could be prevented completely.
Many of the cancers caused by external factors, such as infectious organisms, are also preventable.
A large proportion of cancers of the colorectum could be prevented by avoiding risk factors such as obesity, physical inactivity, consumption of red and processed meat, and by detection and removal of precancerous lesions through screening. Almost all cervical cancers could be prevented by the detection and removal of precancerous cervical lesions, as well as vaccination against human papillomavirus. Screening can detect cancers of the breast, colorectum, and cervix at an early stage when treatment is more likely to be successful.

What Is the Risk of Developing or Dying of Cancer?

Anyone can develop cancer. The risk of being diagnosed with cancer increases with age because most cancers require many years to develop. However, because the Hispanic population is young, a larger proportion of cancers are diagnosed in younger ages; 26% of cancer diagnoses in Hispanics are in those younger than 50 years of age, compared to only 12% in nonHispanic whites. Overall, about 1 in 2 Hispanic men and 1 in 3 Hispanic women will be diagnosed with cancer in their lifetime. The lifetime probability of dying from cancer is 1 in 5 for Hispanic men and 1 in 6 for Hispanic women. Cancer is the leading cause of death among Hispanics, accounting for 21% of deaths overall and 15% of deaths in children.
How Many New Cancer Cases and Deaths Are Expected in 2012? New cases: About 53,600 new cancer cases in men and 59,200 cases in women are expected to be diagnosed among Hispanics in 2012. Prostate cancer is expected to be the most commonly diagnosed cancer in men and breast cancer the most common in women. Cancers of the colorectum and lung will be the second- and third-most commonly diagnosed cancers in Hispanic men, while among women, cancers of the colorectum and thyroid will be second and third, respectively.

Deaths:

About 17,400 Hispanic men and 15,800 Hispanic women are expected to die from cancer in 2012. Among men, lung cancer is expected to account for about 18% of the total, followed by colorectal (11%) and liver (10%) cancers. Among women, breast cancer is the leading cause of cancer death (15%), followed by cancers of the lung (13%) and colorectum (10%).
In contrast, the leading cause of cancer death in non-Hispanic women is lung cancer.
How Have Cancer Rates Changed Over Time? Trends in cancer incidence rates: Cancer incidence rates for Hispanics have been available since 1992. In examining the most recent 10 years for which data are available (2000-2009), incidence rates for all cancers combined among Hispanic men decreased by an average of 1.7% per year (Figure 3), compared to declines of 1.4% among African American men and 1.0% among non-Hispanic white men. Over the same time period, incidence rates among women for all cancers combined decreased annually by 0.3% among Hispanics and 0.2% among non-Hispanic whites, while remaining unchanged among African Americans. It is important to realize that because the US Hispanic population is very dynamic as a result of the influx of new immigrants, trends reflect the cancer risk of incoming Hispanics as well as changes in the risk of established residents. Trends in cancer death rates: Death rates for all cancers combined decreased from 2000 to 2009 by an average of 2.3% per year among Hispanic men and by 1.4% per year among Hispanic women.
The average annual decrease in non-Hispanic whites over the same time interval was 1.5% in men and 1.3% in women.

Major Differences in the Cancer Burden between Hispanics and Non-Hispanic Whites Incidence and death rates: a Table shows differences in cancer incidence and death rates between Hispanics and non-Hispanic whites in the US. For all cancers combined, and for the most common cancers (prostate, female breast, colorectal, and lung), incidence and death rates are lower among Hispanics than among non-Hispanic whites.
Cancers for which rates are higher in Hispanics include stomach, cervix, liver, acute lymphocytic leukemia, and gallbladder. Trends in cancer incidence and death rates among Hispanics for specific cancer sites are shown in Figures 4 and 5, page 6. It is important to reiterate that statistics reported for all Hispanics combined mask wide variation in the cancer burden for specific populations according to country of origin. The cancer burden among Hispanics living in the US is generally similar to that seen in the countries of origin for which data are available. Compared to rates in the US, incidence of breast, colorectal, lung, and prostate cancers are generally lower in Central and South America, whereas incidence rates of cervical, liver, and stomach cancers are higher.5 There is evidence that descendants of Hispanic immigrants have cancer rates that approach those of non-Hispanic whites due to acculturation.6-8 Acculturation, or assimilation, refers to the process by which immigrants adopt the attitudes, values, customs, beliefs, and behaviors of their new culture. The effects of acculturation are complex and can be associated with both positive and negative influences on health.
Among Hispanic immigrants to the US, for example, assimilation may result in improved access to health care and preventive services, as well as the adoption of unhealthy behaviors (e.g., smoking and excessive alcohol consumption) and decreases in dietary quality and physical activity. One study found that overall cancer death rates were 22% higher among US-born than foreign-born Hispanics.Stage distribution and survival: Stage of disease describes the extent or spread of cancer at the time of diagnosis.
Local stage describes a malignant cancer that is confined to the organ of origin. A cancer that is diagnosed at a regional stage has spread from its original site into surrounding organs, tissues, or nearby lymph nodes. Distant-stage cancer has spread to distant organs. In general, the further a cancer has spread, the less likely that treatment will be effective. Although Hispanics have lower incidence and death rates than non-Hispanic whites for the most common cancers, they are generally less likely to be diagnosed with a localized stage of disease, particularly for melanoma and breast cancer. Survival rates indicate the percentage of patients who are alive after a given time period following a cancer diagnosis.

The most commonly used survival measure for the general population is relative survival, which is the ratio of observed survival in a group of cancer patients divided by the expected survival in a comparable group of cancer-free individuals. However, because expected survival data have historically been unavailable for Hispanics, a different measure called cause-specific survival is used to describe survival in this report.

Cause-specific survival is the probability of surviving a specific disease within a certain time period (usually 5 years) after diagnosis.

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