Cancer Burden Among Hispanics Varies Between Puerto Rico, Continental United States

A new report indicates substantially different cancer burden in Puerto Rico’s Hispanic population compared with Hispanic individuals in the continental United States, revealing higher prostate and colorectal cancer rates in Puerto Rico.

The report, which was published in CA: A Cancer Journal for Clinicians, notes variations in cancer risk within the US Hispanic population and in comparison with non-Hispanic white (NHW) individuals, including first-time contemporary incidence and mortality rates for Puerto Rico, which has a 99% Hispanic population.

Cancer is the leading cause of death among Hispanics, the authors noted. According to the report, an estimated 149,100 new cancer cases and 42,700 cancer deaths will occur among Hispanics in the continental United States and Hawaii in 2018.

Overall, the authors found that prostate cancer accounted for nearly 1 in 6 deaths from 2011 to 2015 in Puerto Rico, whereas lung cancer dominated cancer deaths among US Hispanic men. Puerto Rico was the only state or territory included in the analysis where lung cancer was not the leading cause of cancer mortality among men overall, the study found.

From 2011 to 2015, prostate cancer incidence rates in Puerto Rico were 60% higher than in other US Hispanics combined and 44% higher than in NHWs. The study also showed that colorectal cancer death rates for men in Puerto Rico from 2011 to 2015 were 17% higher than in NHWs and 35% higher than other US Hispanics combined.

Despite a lower overall cancer incidence in Hispanics in the continental United States compared with NHWs, the authors indicated that rates among US-born Hispanics are rising, likely due to rapid growth in the Hispanic population. Altogether, Hispanics are less likely than NHWs to be diagnosed with prostate, breast, lung and bronchus, and colorectal cancer, but have a higher risk of infection-related cancers.

Based on the analysis, lung (16%), liver (12%), and colorectal (11%) cancers cause the most deaths among Hispanic men, and breast (16%), lung (13%), and colorectal (9%) among women. Overall, lung cancer accounts for 14% of cancer deaths among Hispanics compared with 25% in the overall population, which reflects both the low smoking prevalence among Hispanics and the older median age at diagnosis for lung cancer, according to the report. Conversely, liver cancer accounts for 12% of cancer deaths in Hispanic men versus 6% in men overall.

Despite an overall lower cancer risk in US Hispanics, the authors concluded that rates among Hispanics are approaching those in NHWs. Given an increasing birth-driven growth in the Hispanic population, the authors estimate that the cancer burden in this population will continue to rise.

“Strategies for reducing cancer risk in Hispanic populations include targeted, culturally appropriate interventions for increasing the uptake of preventive services and reducing cancer risk factor prevalence, as well as additional funding for Puerto Rico-specific and subgroup-specific cancer research and surveillance,” the authors wrote.

Reference

Miller KD, Sauer AG, Ortiz AP, et al. Cancer statistics for Hispanics/Latinos, 2018. CA: A Cancer Journal for Clinicians. 2018. https://doi.org/10.3322/caac.21494