Hispanics have lower cancer screening rates; are diagnosed with cancer at later stages
By Rebecca Siegel, MPH
A new Cancer Facts & Figures for Hispanics/Latinos has been released in conjunction with National Hispanic Heritage Month. This publication is updated every 3 years and is a resource for current information about cancer among Hispanics. But you may be wondering why we produce a 35-page report devoted solely to cancer statistics for Hispanics.
For 60 years the American Cancer Society's Research department has promoted cancer prevention and control by providing cancer data in a user-friendly format called Cancer Facts & Figures. Over the years, new Facts & Figures publications have been developed to highlight a particular cancer type or a specific population. In 2000, to answer the increasing demand for more in-depth information on cancer in the growing Hispanic community, the inaugural Cancer Facts & Figures for Hispanics/Latinos was introduced.
Hispanics Fastest-Growing Minority in US
Promoting cancer prevention and control in the Hispanic community is more important than ever because Hispanics are the largest and fastest growing minority population in the United States. As we learned from the 2010 census conducted by the U.S. Census Bureau, more than 16% of Americans, 50.5 million people, identify themselves as Hispanic. The 43% increase in the Hispanic population over the past decade -- compared to a 10% increase in the total population -- accounted for more than half of the overall population growth. By 2050, approximately 30% of all Americans will be Hispanic, which means that more and more new cancer patients will be Hispanic.
And what's more, cancer is the leading cause of death among Hispanics (heart disease causes the most deaths among blacks and whites). Poverty and reduced access to medical services worsen the Hispanic cancer burden: 27% of Hispanics are poor (versus 10% of non-Hispanic whites), and 31% are uninsured (versus 12% of non-Hispanic whites). As a result, compared to non-Hispanic whites, Hispanics have lower cancer screening rates and are diagnosed with cancer at later stages, when treatment options are more limited and less successful.
Hispanics a Diverse Population
It is important to realize that although cancer statistics are usually given for Hispanics as a whole, the Hispanic community is made up of many diverse subgroups with distinct cancer patterns. This is because Hispanics living in the U.S. come from many different countries and cultures (e.g., Mexico, Central and South America, Cuba, etc). Although cancer differences within the Hispanic population haven't been addressed in the past, researchers have recently begun to look within subpopulations to uncover these striking variations. A study of Hispanics in Florida found that the risk of cancer was generally lowest among Mexicans and highest among Cubans and Puerto Ricans, whose risk was more similar to non-Hispanic whites. In fact, the overall cancer death rate among Cuban men was double that among Mexican men, 328 (per 100,000 men) versus 163, respectively. This is largely because Cuban men are much more likely than Mexican men to smoke, which increases their risk of about 20 different cancers.
New immigrants to the US have the same cancer risk here as they did in their home country. Over time, however, a fascinating shift occurs. The next generations increasingly exhibit cancer risk that is more similar to Americans because of acculturation, i.e., changes in behavior and diet more consistent with an American lifestyle. For example, the incidence of colorectal (colon) cancer among Mexicans living in Florida is more than double that of Mexicans in Mexico. The reasons for this dramatic increase are complex and not completely understood, but are undoubtedly related to environmental differences in the U.S., like fewer affordable healthy food options and less opportunity for physical activity. Diet and exercise are both related to colon cancer risk.
Although Hispanics have a lower risk than whites or blacks for the most common types of cancer (lung, breast, prostate, and colon), they have a higher risk for cancers related to infectious agents. One of these is cervical cancer, which is caused by persistent infection with the human papillomavirus (HPV). Cervical cancer incidence rates among Hispanic women are about 60% higher than those among non-Hispanic whites. We have a lot of tools to fight cervical cancer. With the HPV vaccine as well as effective screening with the Pap and HPV tests, we truly have the potential to end cervical cancer for future generations. Unfortunately, rates of both HPV vaccine completion and Pap testing are lower among Hispanics than non-Hispanic whites. Advances in cancer prevention are meaningless unless we can apply what we know to all population groups, particularly those who are most disadvantaged.
Although cancer incidence and death rates in this population are decreasing, we can do more. Cancer Facts & Figures for Hispanics/Latinos educates cancer control advocates and policy makers about the Hispanic cancer burden. This knowledge can be used to promote cancer prevention programs targeted at specific Latino groups within their communities that not only increase cancer screening and vaccination completion rates, but also promote quitting smoking and healthy food choices. Indeed, the broad implementation of proven cancer control strategies would substantially reduce suffering and deaths from cancer in the Hispanic community.
Siegel is an epidemiologist for the American Cancer Society.