U.S. Hispanics have higher rates of infection-associated cancers than whites
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Hispanic adults had lower rates of overall cancer incidence between 2014 and 2018, but higher rates of liver and stomach cancers compared with whites, according to study results published in CA: A Cancer Journal for Clinicians.
In addition, the American Cancer Society’s 2021 Cancer Statistics for the U.S. Hispanic/Latino Population report showed Hispanic women had a higher incidence of cervical cancer than white women.
“ [Although] this is not new, this is concerning because many of these cancers are caused by potentially modifiable risk factors or could be prevented through screening, such as cervical cancer. Yet, the high number of Hispanic men and women who do not have health insurance substantially impedes making progress against these cancers,” Kimberly D. Miller, MPH, researcher at American Cancer Society, told Healio. “The ongoing impetus for our research is the persistent lack of health equity for Hispanic Americans, who account for almost one-fifth of the U.S. population and yet are one of the most underserved communities. Given these disparities, we expect to see an increase in the cancer burden within the Hispanic community throughout time as the population continues to grow and age. Research has already shown that Hispanic men and women born in the U.S. have cancer rates that approach those of whites.”
The report, published every 3 years, includes the most recent population-based data on cancer occurrence, risk factors and screening for the U.S. Hispanic population. It showed that approximately 176,600 new cancer cases and 46,500 cancer deaths will occur among Hispanic men and women across the continental U.S. and Hawaii in 2021.
Despite a 25% to 30% lower incidence rate among Hispanic individuals between 2014 and 2018, lower mortality from 2015 to 2019 for all cancers combined and lower rates for the most common cancers, the gap appears to be diminishing. For example, the rate ratio for colorectal cancer incidence among Hispanics vs. whites decreased from 0.75 (95% CI, 0.73-0.78) in 1995 to 0.91 (95% CI, 0.89-0.93) in 2018.
In addition, Hispanic individuals had a twofold higher incidence of liver and stomach cancers than whites, and cervical cancer incidence was 32% higher among Hispanic women in the continental U.S. and Hawaii and 78% higher among women in Puerto Rico compared with white women. Researchers also observed a lower prevalence of localized-stage breast cancer among Hispanic vs. white women (59% vs. 67%).
“In addition to persistent disparities in infection-related cancers, we see the impact on lack of health care access in the occurrence of other cancers, too,” Miller said. “For example, Hispanic people have historically had much lower colorectal cancer incidence rates than whites, but that gap has narrowed considerably over time due to more rapid declines among the latter. Part of this is likely related to screening; colorectal cancer screening in Hispanic men and women continues to lag behind that in whites.”
Cancer rates often are presented in aggregate for Hispanics due to data limitations, according to Miller, but it is important to note that rates for U.S.-born Hispanic individuals approach or surpass those of whites.
“There is also a wide variation in rates between people who identify with different origin groups, such as Mexican vs. Cuban. As such, the cancer profile for Hispanic people in different states and within different communities varies substantially,” Miller added.
Although Miller said she was not surprised by these findings, as researchers have been reporting for years that access to care continues to lag behind among Hispanic men and women despite advances made with the Affordable Care Act, she continues to be surprised by how large the insurance gap is — even in states that have expanded Medicaid — and is concerned for what this might mean for the Hispanic community in the future.
“Some of the disparities we see in cancer outcomes for the Hispanic community are due to obstacles in navigating the health care system, transportation and obtaining time off work,” she said. “It is essential for health care providers to have cultural proficiency and understand these issues to achieve the best outcomes for their Hispanic patients.”
For more information:
Kimberly D. Miller, MPH, can be reached at American Cancer Society, 3380 Chastain Meadows Parkway NW, Suite 200, Kennesaw, GA 30144; email: kimberly.miller@cancer.org.
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