Abstract 1902: Lung cancer incidence by detailed race-ethnicity
Authors: Cranford Hannah M. 
Published: May 2023

Abstract
Despite recent incidence and mortality declines, lung cancer (LC) is still the second most common and deadliest cancer in the US. Yet, LC incidence and proportion of never-smokers among the heterogeneous racial-ethnic populations that compose Blacks and Hispanics, normally characterized in aggregate, are unknown. We used LC data from the Florida state cancer registry, 2012-2018, to compute first-ever LC age-adjusted incidence rates (AAIR) for specific populations: US-born Black, Caribbean-born Black, Mexican, Puerto Rican, Cuban, Dominican, Central American, and South American. For comparison, we computed Fay and Feuer incidence rate ratios (IRR) with non-Hispanic Whites as reference. We also assess the proportions of LCs that occurred among never-smokers by detailed race-ethnicity. We analyzed 120,550 LC cases in total. LC proportions in never-smokers varied from 9.4% in non-Hispanic White males to 66.7% in Caribbean-born Black females. AAIR in Cuban males was the highest of Hispanics, while those for US-born Blacks were over three times that of Caribbean-born Blacks. US-born Black men have significantly higher AAIRs than White men [IRR:1.14; 95%CI:1.11-1.18]. The lowest IRRs were observed among Caribbean-born Black and Central American females. This novel analysis of Florida LC incidence and never-smoker proportions by detailed race-ethnicity furthers knowledge, characterizing LC patterns across US minorities. Hispanic LC rates, higher than national rates, are heavily influenced by the high proportion of Cuban males with a documented high prevalence of smoking. Larger LC proportions in never-smokers for Central Americans and Caribbean-born Blacks show vast heterogeneity by detailed race-ethnicity and align with lower smoking prevalence. Aggregation of non-Hispanic Blacks or Hispanics obscures inherent disparities by origin. Understanding the potential effects of nativity on LC rates in US minorities is important for targeting public health measures for LC diagnosis, treatment, and prevention.
Incidence Rates and Rate Ratios of Lung Cancer and Never-Smoker Proportions- Detailed Race-Ethnicity Race-Ethnicity Total Ratea (95%CI) Rate Ratio (95%CI) Never-Smokers Total Ratea (95%CI) Rate Ratio (95%CI) Never-Smokers MALES MALES MALES MALES FEMALESb FEMALESb FEMALESb FEMALESb Non-Hispanic White 49,043 71.4 (70.8-72.1) Reference 9.4 47,088 61.0 (60.4-61.6) Reference 13.3 Non-Hispanic Black 5,553 63.5 (61.8-65.3) 0.89 (0.86-0.92) 11.9 4,157 36.0 (34.9-37.1) 0.59 (0.57-0.61) 27.3 US-Born Black 4,852 81.7 (79.3-84.2) 1.14 (1.11-1.18) 9.8 3,600 46.4 (44.8-48.0) 0.76 (0.73-0.79) 21.4 Caribbean-Born Black 654 26.2 (24.1-28.4) 0.37 (0.34-0.40) 26.0 515 14.9 (13.6-16.3) 0.24 (0.22-0.27) 66.7 Non-Hispanic AP 512 25.5 (23.2-27.9) 0.36 (0.32-0.39) 24.8 518 18.8 (17.2-20.6) 0.31 (0.28-0.34) 59.8 Hispanic 7,038 49.8 (48.6-51.0) 0.70 (0.68-0.71) 15.3 5,024 26.4 (25.7-27.1) 0.43 (0.42-0.45) 35.8 Mexican 276 36.8 (31.7-42.4) 0.52 (0.44-0.59) 17.3 153 16.8 (14.0-19.8) 0.27 (0.23-0.33) 40.3 Puerto Rican 1,224 43.7 (41.2-46.4) 0.61 (0.58-0.65) 13.8 1,026 28.8 (27.1-30.7) 0.47 (0.44-0.50) 29.4 Cuban 4,189 65.6 (63.6-67.6) 0.92 (0.89-0.95) 14.7 2,491 31.7 (30.5-33.0) 0.52 (0.50-0.54) 34.1 Dominican 207 44.2 (37.8-51.2) 0.62 (0.53-0.72) 23.3 198 25.2 (21.8-29.1) 0.41 (0.36-0.48) 45.2 Central American 208 24.1 (20.6-28.1) 0.34 (0.29-0.39) 22.8 258 16.3 (14.3-18.5) 0.27 (0.23-0.30) 50.0 South American 778 33.4 (31.0-36.0) 0.47 (0.43-0.50) 16.3 789 22.9 (21.3-24.6) 0.37 (0.35-0.40) 43.3 a. Rates are average annual per 100,000 age adjusted to the U.S. 2000 Standard Population; b. Includes n=39 identified as non-binary. Abbreviation: CI, Confidence Interval; API, Asian/Pacific Islander
Citation Format: Hannah M. Cranford. Lung cancer incidence by detailed race-ethnicity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1902.