Examining Differences in Cancer Among Hispanics

Study reports that cancer type and mortality differs among ethnic groups, suggesting a need for targeted public health efforts.

A new study suggests that the growing Hispanic population in the United States may experience cancer very differently depending on their nation of origin.

Hispanics accounted for 17 percent of the U.S. population in 2014 and are expected to account for 29 percent of the population by 2060. For the most part, health data such as cancer incidence and mortality rates are calculated on an aggregate basis, with all Hispanics under one label.

A study recently published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research (AACR), examined Hispanic cancer data according to the major ethnic groups: Cuban, Puerto Rican, Mexican, Central American, Dominican, and South American. The study concluded that cancer types and mortality rates vary considerably among the different groups.

Lead author Paulo S. Pinheiro, MD, PhD, an associate professor of epidemiology at the School of Community Health Sciences at the University of Nevada, Las Vegas, said that overall, Hispanics have a 30 percent lower risk of dying of cancer than non-Hispanic whites. Hispanics had higher mortality rates from stomach and prostate cancers, but lower rates for lung, pancreas, and breast cancers compared with non-Hispanic whites.

Analyzing the data by narrower ethnic group, however, revealed some significant differences. For example, the Cuban population had the highest risk of dying of lung cancer. Pinheiro said this was unsurprising, since Cubans reported a high prevalence of smoking.

The study also showed that prostate cancer mortality among Dominicans was nearly double that of the non-Hispanic whites. Pinheiro said the disparity may reflect the fact that many Dominicans have African ancestry; prostate cancer incidence and mortality is higher in men of African descent.

Among women, Cuban and Puerto Rican women had higher mortality rates from breast cancer than the other groups. Pinheiro said these women tended to follow the American trend of having fewer children, which has been shown to increase breast cancer risk.

Pinheiro said his study findings indicate the benefits of looking beyond broad demographic labels to examine the factors that affect cancer risk for specific ethnic groups.

“Hispanic populations are all different, reflecting their country of origin, cultural experiences, and socioeconomic status,” said Pinheiro. “If we can detect the differences among them, we can more easily identify public health strategies that could decrease their cancer risk and improve health outcomes.”

Pinheiro said that the study findings suggest that some ethnic groups may benefit from more targeted public-health efforts. For example, he noted, a city with a large Dominican population could run advertising campaigns encouraging men to get screened for prostate cancer.

He added that physicians should counsel their Hispanic patients to follow all recommendations for cancer screening.

“There is undoubtedly better access to screening here than in their home countries, so they should take advantage of it,” Pinheiro said. “Depending on where they come from, their doctor could have a more targeted conversation about their cancer risk.”

Pinheiro said his team chose to base this study on Florida data because it is the only state with statistically significant representation from all major Hispanic ethnic groups. He said he expects that the trends shown in this study would apply to Hispanics in most parts of the United States, but may differ in states like California and Texas, where many Hispanic families have lived for several generations and may have adopted more Westernized diets and lifestyles.

A limitation of the study is that the amount of time spent in the United States was not available for each study participant.