Abstract B75: Diversity in cancer mortality within Hispanic populations in the United States - Prevailing patterns and atypical findings
Authors: Pinheiro Paulo S. , Callahan Karen E. , Jin Hongbin 
Published: March 2017

Abstract
Introduction: Hispanics are the largest minority population in the United States (US), numbering 55 million. Cancer is the leading cause of death among Hispanic men and women. Differences in the burden of cancer mortality within Hispanic subpopulations have not been systematically quantified in the US, largely due to challenges in the data, and the focus on only three Hispanic populations, Mexicans, Puerto Ricans and Cubans.
Methods: Cancer mortality rates of residents of Florida were computed, specifically focusing on the 6 different Hispanic populations: Mexicans, Puerto Ricans, Cubans, Central Americans, South Americans, and Dominicans. Hispanic subgroup membership was ascertained based on race, ethnicity and birthplace. Population data was derived from the Census 2010. We compared the cancer mortality of Hispanics as an aggregate group as well as the 6 subgroups to cancer mortality of non-Hispanic whites (NHW) and blacks (NHB) using age-adjusted mortality ratios obtained from negative binomial regression models.
Results: We analyzed 205,369 cancer deaths from 2008-2012, of which 22,042 occurred in Hispanic populations. The overall mortality rates were lower for Hispanics (159 and 100 per 100,000 for males and females, respectively) than for NHW (204 for males and 145 for females per 100,000), largely attributable to low rates of lung and breast cancers, possibly due to lower tobacco prevalence and a history of higher fertility among Hispanics. However, Hispanics had a higher risk of death than NHW for two infection-related cancers, liver and stomach, particularly elevated for Mexicans, Central Americans, and Puerto Ricans. There was no difference between Hispanics, RR=0.97 (95% CI: 0.84-1.13) and NHW women for cervical cancer mortality, except among Puerto Rican women, who had a higher risk than NHW, RR=1.34 (95% CI: 1.02-1.75). Cubans had the highest mortality burden of all Hispanic subgroups for colorectal cancer, RR=1.10 (95% CI: 1.01-1.20), prostate cancer, RR=1.15 (95% CI: 1.07-1.25), and endometrial cancer RR=1.22 (95% CI: 1.06-1.41) compared to NHW. Dominican men had a significantly higher risk, RR=1.87 (95% CI: 1.43-2.46) of prostate cancer death than NHW men.
Discussion: Hispanics overall had lower cancer mortality compared to NHW and NHB, yet there is compelling heterogeneity within the Hispanic population. Cubans and Puerto Ricans had significantly higher rates than Central Americans, Dominicans, South Americans, and especially Mexicans. The finding that the highest cancer mortality rates are found among the populations with longer immigration and/or settlement histories, especially in diet and obesity-related cancers such as colorectal, endometrial, and prostate suggests that acculturation plays a role in the cancer mortality burden among Hispanics. Yet, a few Hispanic subgroups diverge significantly from common patterns, with additional implications for Public Health. Meriting attention is the high colorectal cancer mortality among Cubans, liver cancer mortality among Puerto Rican men and women, and prostate cancer mortality among Dominican males.
Citation Format: Paulo S. Pinheiro, Karen E. Callahan, Hongbin Jin. Diversity in cancer mortality within Hispanic populations in the United States - Prevailing patterns and atypical findings. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B75.