Cancer rates and deaths are declining among Hispanics in the United States, according to a new statistical report by the American Cancer Society. Cancer Facts and Figures for Hispanic/Latinos 2003-2005 details the types of cancer prevalent among Hispanics, and identifies some of the risk factors and barriers to care for people in this group.

Overall, the report found, Hispanics/Latinos are less likely to develop cancer or die from it than non-Hispanic whites. This holds true even for the four most common cancers: lung, breast, prostate and colorectal.

However, Hispanic people in the United States have higher rates of other types of cancer, including cancers of the stomach, cervix, and liver. They're also less likely to have recommended tests and exams for the early detection of prostate, colon, and cervical cancer, and are more likely to be diagnosed at a later stage, when the disease is more difficult to treat.

"The report is a classic example of a good news, bad news situation," wrote Elmer Huerta, MD, MPH, in CA: A Cancer Journal for Clinicians (Vol. 53, No. 4: 205-207).

Among the good news: Hispanics have lower levels of tobacco use, which is responsible for about 30% of cancer deaths in the United States. Just over 15% of Hispanic adults reported smoking in 2002, compared to more than 22% of all adults in the US. And only 7% of Hispanic teenagers smoke, compared to 17% of white non-Hispanic teens.

Mammography has also increased among Hispanic women, and rates are higher in this group than among non-Hispanic whites. Breast cancer rates are also about 40% lower in Hispanic women compared to non-Hispanic white women.

Nevertheless, Hispanic women who do get breast cancer are more likely to be diagnosed at a later stage, and breast cancer is the leading cause of cancer death among Hispanic women. (Lung cancer is the number one cause among non-Hispanic white women, as it is among Hispanic and non-Hispanic men.)

According to the report, about 67,400 Hispanic people in the United States can be expected to get cancer in 2003, and about 22,100 can be expected to die from cancer. From 1992-1999, the period studied to predict current trends, cancer occurrences and deaths dropped slightly among both Hispanic men and women.

Hispanics are the fastest growing minority in the United States, according to data from the US Census Bureau. More than 35 million people (12.5% of the US population) were classified as Hispanic in 2000. Hispanics include people of all races with ancestry from many different countries.

"Hispanics or Latinos are a very heterogeneous group, since people from Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish cultures -- regardless of race – are considered Hispanic," said Vilma Cokkinides, director for risk factor surveillance at the American Cancer Society.

This variation among Hispanics means that cancer risk factors and rates also can vary between, say, Mexican-Americans and Cuban-Americans. But overall, there are certain characteristics that distinguish Hispanics of all types from other groups when it comes to cancer.

"As a group they have very different cancer risks and rates compared to other ethnic groups," Cokkinides said.

For instance, Hispanics are more likely to be obese or overweight than non-Hispanic whites. Hispanics also get less exercise. Maintaining a healthy body weight and getting regular physical activity can reduce the risk of developing certain cancers.

Hispanics in the United States are also less likely to be screened for certain types of cancer, even though screening exams can save lives by finding cancers at their earliest stages, when they are easiest to treat.

Just over 15% Hispanic men and women 50 and older got screened for colon cancer with a fecal occult blood test (FOBT) in 2001. Roughly 46% of Hispanic men that age were screened for prostate cancer with a PSA test. By contrast, 24% of whites and more than 21% of African Americans that age had colon cancer screening with FOBT that year, while 58% of white men and 57% of African-American men that age had the PSA test.

Those statistics highlight unequal access to health care that must be addressed, said Huerta, who is director of the Cancer Preventorium, a cancer screening and prevention center at Washington Cancer Institute in Washington, DC. They also raise questions about the best way to educate the diverse Hispanic community about cancer, he added.

Some of the difference in screening rates can be pinned on poverty. Hispanics are the poorest minority group in the United States, Huerta wrote, and they have the highest uninsured rate of all ethnic and racial groups in the country. Lack of insurance and money to pay for medical services often translate into failure to get preventive care like cancer screening.

Language and culture may also be barriers to care, Huerta said. Many Hispanics, particularly first-generation immigrants, may not know what services are available to them, or may not speak English well enough to understand medical information.

Cokkinides said the new report could help eliminate some of those barriers. "That's the primary reason we are doing this report, to identify areas and provide focus for community health advocates and other groups in addressing cancer among Hispanics."

Huerta said health care advocates must develop programs specifically for Hispanic Americans that explain information about prevention and early detection. A system of "cancer navigators" who help patients make their way through the medical system could also be helpful, he said.