The fact sheet summarizes cancer facts related to the Hispanic/Latino population. The document is organized into seven sections: Who We Are, Causes/Etiology, Patient/Provider Communication, Screening, Disparities, Outcomes, and References. See more at Intercultural Cancer Council Records

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The Texas Medical Center Library DigitalCommons@TMC Informational and Promotional Materials Intercultural Cancer Council Records 2011 Cancer Facts: Hispanic/Latinos and Cancer Intercultural Cancer Council Follow this and additional works at: https://digitalcommons.library.tmc.edu/info_promo  Part of the Public Health Commons, and the Social Justice Commons Recommended Citation Intercultural Cancer Council, "Cancer Facts: Hispanic/Latinos and Cancer" (2011). Informational and Promotional Materials. 10. https://digitalcommons.library.tmc.edu/info_promo/10 This Article is brought to you for free and open access by the Intercultural Cancer Council Records at DigitalCommons@TMC. It has been accepted for inclusion in Informational and Promotional Materials by an authorized administrator of DigitalCommons@TMC. For more information, please contact digcommons@library.tmc.edu. Hispanics/Latinos and CancerWe are called “Hispanic” orsometimes “Latino” to describeour ethnic background. However, as apopulation we are more accuratelyreferred to as a mosaic of cultures. Inreality, the various Hispanic subgroupsreflect profound differences inethnicities, cultures, and origins, andhave remarkably few characteristics incommon. For example our populationcovers the racial spectrum; asHispanics we can be White, AfricanAmerican, Asian or Pacific Islander, orNative American. Moreover, ourdiversity extends to nationality,customs, heritage, lifestyles, andsocioeconomic status. Whilesimilarities among us do exist,particularly in language (Spanish) andreligion (Catholic), we have deeplyembedded dissimilarities inbackground and life experiences thatinfluence our health. In practice, thismeans that one should use caution inmaking broad generalizations aboutthe Hispanic/Latino population.In 2009, Hispanics/Latinosnumbered 48.5 million and made up16% of the population.(1) By 2050, wewill represent almost a quarter of thecountry’s population (over 100million).(1) Yet, in 2004, the medianincome for our Hispanic householdswas $36,000, which was considerablylower than the $48,000 medianincome for our non-Hispanic/Latinowhite counterparts. In the same year,our poverty rates were over three timeshigher (22% vs. 9%) when comparedto non-Hispanic/Latino whites. In 2006,only 2% of the Hispanic population, 25and older, completed a bachelor’sdegree or higher.(2)Nearly two-thirds of all Hispanics/Latinos in the U.S. are of Mexicanorigin (62.5%) and 9.6% of PuertoRican origin, while people of Cubanorigin, Central and South Americanorigin, and other Hispanics/Latinoseach account for 4.3%, 14.3% and6.6%, respectively.(2)WHOWEARECancer FactsProject DirectorNicholas K. Iammarino, PhD, CHESResearch AssistantsMohammed Ansar AhmedPrem RamkumarCauses/Etiology The underuse of adjuvant therapy is evidenced in minoritywomen diagnosed with early-stage breast cancer. In a largestudy of women in NewYork City, this treatment wasunderused in 23% of Hispanic/Latino women, compared toonly 16% of non-Hispanic/Latino white women.(3) Hispanic patients are less likely to receive surgical resectionsfor early-stage lung cancer than non-Hispanic/Latino whites.(4) Latinos are more likely to undergo lung resection at low-volume hospitals, after controlling for patient and hospitalfactors. In addition, hospital volume is inversely associatedwith inpatient mortality, suggesting a disparity that may notbe accounted for by racial concentration or limited hospitalchoice.(5) Lesion thickness is the most important predictor of prognosisin melanoma patients. An analysis of melanoma incidenceand mortality found that Hispanics/Latinos had a largerproportion of thick lesions than thin lesions. Only 43.9% ofinvasive melanomas in Hispanic/Latino males were less than0.75 mm at diagnosis, compared to 53.7% of those in non-Hispanic/Latino white males.(6) A known risk factor for colorectal cancer is not consumingenough fruits and vegetables. Consumption of fruits andvegetables is particularly low among Latino men, with only5-19% reporting consuming three or more servings ofvegetables per day.(7) The increased incidence of gastric and liver cancer amongHispanics/Latinos may be partially explained by an increasedrisk of exposure to certain infectious agents such asHelicobacter (H. pylori) and the Hepatitis C virus.(8)Screening A national cancer survey found that only 53.5% of Hispanic/Latino men were aware of the prostate-specific antigen (PSA)screening test for prostate cancer. This is a significantly lowerawareness than for non-Hispanic/Latino white men (75.4%).(9) Since Medicare began reimbursing colonoscopies for theaverage-risk population, disparities in screening ratesbetween Hispanics/Latinos and non-Hispanic/Latino whiteshave increased, while disparities in screening rates for non-Hispanic/Latinos whites and African Americans have beenreduced.(10)These ICC Cancer Fact Sheets wereupdated through an educational grantfrom Ortho Biotech.Hispanics/Latinos and Cancer2 In 2003, 66.1% of Hispanic/Latino women aged 40 and olderhad regular screening mammograms compared to 70.8% ofnon-Hispanic/Latino whites.(11) From 2000-2003, of the 74.7% of Hispanic/Latina womenaged 18 and older who had a pap smear, 64.4% wereuninsured, compared to 80.2% of non-Hispanic/Latinawhites who had a pap smear of whom 59.3% wereuninsured.(11) Lower acculturated Hispanic/Latino women are less likely toever have received a Pap smear screening.(12) Hispanic/Latino women, who speak mostly Spanish and arenot up-to-date with cervical cancer screening guidelines, areless likely to receive a recommendation for a Pap smearcompared to those who are highly English proficient.(13) In a recent study of skin cancer awareness among high schoolstudents, Hispanic/Latino students were less aware than theirnon-Hispanic/Latino white peers of skin self-examination.Furthermore, they were also less likely than non-Hispanic/Latino white students to wear sunscreen, sun-protectiveclothing, and perceived themselves to be at lower risk for skincancer than non-Hispanic/Latino white students.(14)Patient/Provider Communication In a survey of Latinas and non-Latinas referred forcolposcopy, Latinas were significantly more likely to reportfear of test results or an inability to communicate with theirproviders in Spanish as barriers to obtaining screening Paptesting.(15) Compared to non-Hispanic/Latino white physicians, Latinophysicians were significantly less involved in clinical trialsand found less value in them. This in turn, may influencetheir decision to refer patients to be enrolled in clinicaltrials.(16) Women who report not speaking English well have lowerrates of screening for breast and cervical cancer. Moreover,these differences are not accounted for by being native to theU.S., having different social or demographic factors, and/orthe length of residence in the U.S., which suggests acommunication barrier to access.(17) The probability of having a screening mammogram is greaterin women who have personal physicians, who seek healthcare at their physician’s offices, and who have health carecoverage. Hispanic/Latino women are less likely than non-Hispanic/Latina white women to have these protectivefactors.(18)Disparities The incidence of thick (>1.5 mm) melanomas is increasing ata higher rate among Hispanics/Latinos compared to non-Hispanic/Latino whites. For Hispanic/Latino males, theannual increase is 15.4% compared to 11.6% among non-Hispanic/Latino white males. For Hispanic/Latino females,the incidence of thick tumors is increasing at a rate of 8.9%per year as opposed to only 0.7% for non-Hispanic/Latinowhite females.(6) Hispanic/Latino and African American/black women are lesslikely to be diagnosed with early-stage breast cancer thannon-Hispanic/Latino white women.(19) Women living below the poverty line are more likely to bepositive for high-risk serotypes of the human papillomavirus(HPV), the causative organism for cervical cancer. Amongthese women, Mexican American ethnicity was mostassociated with increased prevalence of HPV.(20) Among women diagnosed with ovarian cancer,Hispanic/Latino women are less likely than non-Hispanic/Latino white women to receive recommendedcomprehensive surgery.(21) In a large retrospective analysis of melanoma patients,Hispanic/Latino patients were significantly more likely tohave metastases at the time of diagnosis (16%) than non-Hispanic/Latino white patients (9%).(22) Cervical cancer incidence is the highest among Hispanic/Latino women when compared to all other ethnic groups. In2004, the incidence rate among Hispanics/Latinos was 13.8per 100,000 compared to 8.5 among non-Hispanic/Latinowhites.(23-25)Hispanics/Latinos and Cancer 3 Hispanics have a higher age-specific mortality rate from skincancer than non-Hispanic/Latino whites aged 45 years andyounger.(26) In a survey to determine prostate cancer knowledge amonguninsured men, Hispanic/Latino men were more likely toscore lower than other ethnic populations.(27) Hispanic/Latino women presenting with breast cancer aremore likely to have Stage IV disease, to have poorlydifferentiated tumors, larger tumors, and to have estrogenreceptor-negative tumors compared to non-Hispanic/Latinowhite women. These factors all portend a poorer prognosis.(28)Outcomes The five most common types of cancers by incidence inHispanic/Latino men are prostate, colon and rectum, lungand bronchus, urinary bladder, and non-Hodgkin lymphoma.The five most common cancers causing death in Hispanic/Latino men are lung and bronchus, prostate, colon andrectum, liver and intrahepatic bile duct, and pancreas.(25) The five most common types of cancers by incidence inHispanic/Latino women are breast, colon and rectum, lungand bronchus, corpus and uterus, and non-Hodgkinlymphoma. The five most common cancers causing death inHispanic/Latino women are breast, lung and bronchus, colonand rectum, pancreas, and ovarian.(25) The incidence rate of gastric cancer in Hispanic/Latino men(17.8 per 100,000) and women (10 per 100,000) whencompared with non-Hispanic/Latino white men (10.8) andwomen (5.0) is higher.(25) The incidence rate of liver and bile duct cancer inHispanic/Latino men (13.5 per 100,000) and women (5.8 per100,000) is higher than that of non-Hispanic/Latino whitemen (7.2 per 100,000) and women (2.9 per 100,000).(25) The mortality rate for cervical cancer among Hispanic/Latinowomen is 3.3 per 100,000 compared to 2.6 per 100,000 forwomen of all races.(25) The incidence of esophageal and gastric cancer differs byhistology between Hispanics/Latinos and other ethnicities.The incidence of squamous cell carcinoma is 48% higheramong Hispanic/Latino men than among non-Hispanic/Latino white men, and the incidence of cardiaadenocarcinoma was 20% higher among Hispanic/Latinowomen than among non-Hispanic/Latino white women. (29) In a study of adults over 50 years old, the rates ofHispanics/Latinos reporting sigmoidoscopy or colonoscopywithin the past five years was only 27.9%, the lowest of all theethnic groups studied compared to non-Hispanic/Latinowhites (48.0%), African Americans/blacks (32.8%), AsianAmericans (33.3%), and “other” (33.3%). (30) Among Mexican American and Puerto Rican women, cervicalcancer incidence is two to three times higher than in non-Hispanic/Latino white women. (31)References1. U.S. Census Bureau. State and County QuickFacts 2009.Updated August 2010. Available at:http://quickfacts.census.gov/qfd/states/00000.html.Accessed November 2010.2. U.S. Census Bureau. The American Community-Hispanics2004. Available at:http://www.census.gov/prod/2007pubs/acs-03.pdf.Accessed October 2010.3. Bickell NA,Wang JJ, Oluwole S, et al. Missed Opportunities:Racial Disparities in Adjuvant Breast Cancer Treatment.J Clin Oncol. 2006;24(9):1357-62.4. Wisnivesky JP, McGinn T, Henschke C, Hebert P, IannuzziMC, Halm EA. Ethnic Disparities in the Treatment of Stage INon-Small Cell Lung Cancer. Am J Respir Crit Care Med.2005;171(10):1158-63.5. Neighbors CJ, Rogers ML, Shenassa ED, et al. Ethnic/RacialDisparities in Hospital Procedure Volume for LungResection for Lung Cancer.Med Care. 2007;45(7):655-63.6. Cockburn MG, Zadnick J, Deapen D. Developing Epidemicof Melanoma in the Hispanic Population Of California.Cancer. 2006;106(5):1162-68.21. Goff BA, Matthews BJ,Larson EH, et al. Predictorsof Comprehensive SurgicalTreatment in Patients withOvarian Cancer. Cancer.2007;109:2031-42.22. Hu S, Soza-Vento RM,Parker DF, et al. Comparisonof Stage at Diagnosis of Melanoma Among Hispanic, Black,andWhite Patients in Miami-Dade County, Florida. ArchDermat. 2006;142(6):704-08.23. Detailed Guide: Cervical CancerWhat Are the Key Statisticsabout Cervical Cancer? American Cancer Society. Availableat: http://www.cancer.org/Cancer/CervicalCancer/DetailedGuide/cervical-cancer-key-statistics. AccessedOctober 2010.24. Comparing Cervical Cancer by Race and Ethnicity. Centerfor Disease Control. Available at: http://www.cdc.gov/cancer/cervical/statistics/race.htm. Accessed October 2010.25. Ries LAG, Melbert D, Krapcho M, et al., editors. SEERCancer Statistics Review, 1975–2004. National CancerInstitute. Based on November 2006 SEER data submission.Available at: http://seer.cancer.gov/csr/1975_2007/index.html. Accessed October 2010.26. Wong M, Tagawa T, Hsieh HJ, Shapiro MF, BoscardinWJ,Ettner SL. Differences in Cause-Specific Mortality BetweenLatino andWhite Adults.Med Care. 2005;43(10):1058-62.27. Deibert CM, Maliski S, Kwan L, Fink A, Connor SE, LitwinMS. Prostate Cancer Knowledge among Low IncomeMinority Men. J Urol. 2007;177(5):1851-55.28. Watlington AT, Byers T, Mouchawar J, et al. Does HavingInsurance Affect Differences in Clinical PresentationBetween Hispanic and Non-HispanicWhiteWomen withBreast Cancer? Cancer. 2007;109(10):2093-99.29. Wu X, Chen VW, Andrews PA, Ruiz B, et al. Incidence ofEsophageal and Gastric Cancers Among Hispanics, Non-HispanicWhites and Non-Hispanic Blacks in the UnitedStates: Subsite and Histology Differences. Cancer CausesControl. 2007;18(6):583-93.30. Vlahov D, Ahern J, Vazquez T, et al. Racial/EthnicDifferences in Screening for Colon Cancer: Report from TheNewYork Cancer Project. Ethn Dis. 2005;15(1):76-83.31. Ramirez, A. G., & Suarez, L. Hispanic Cultures. In L. Breslow(Ed.), Encyclopedia of Public Health NewYork, NY:Macmillan Reference USA – Gale Group, 2001; 2:565-567.Information provided by theIntercultural Cancer Council713.798.4614 • 713.798.3990 (FAX)Email: icc@bcm.edu • Website: http://iccnetwork.orgCancer Fact Sheets may be downloaded in printable Adobe Portable Document Format (pdf) from:http://iccnetwork.org/cancerfacts7. Ramirez AG, Suarez L, Chalela P, et al. Cancer Risk Factorsamong Men of Diverse Hispanic or Latino Origins. PrevMed. 2004;39(2):263-69.8. Jemal A, Murray T,Ward E, et al. Cancer Statistics 2005. CA:Cancer Journal for Clinicians. 2005;55:10-30.9. McFall SL. Use and Awareness of Prostate Specific AntigenTests And Race/Ethnicity. J Urol. 2007;177(4):1475-80.10. Shih YC, Zhao L, Elting LS. Does Medicare Coverage ofColonoscopy Reduce Racial/Ethnic Disparities in CancerScreening among the Elderly? Health Aff. 2006;25(4):1153-62.11. American Cancer Society. Cancer Facts and Figures forHispanic/Latinos, 2006-2008. Atlanta, Ga: 2006.12. Shah M, Zhu K,Wu H, Potter J. Hispanic Acculturation andUtilization of Cervical Cancer Screening in the U.S. PrevMed. 2006;42(2):146-49.13. De Alba I, Sweningson JM. English Proficiency andPhysicians’ Recommendation of Pap Smears amongHispanics. Cancer Detect Prev. 2006;30(3):292-96.14. Fangchao M, Collado-Mesa F, Hu S, Kirsner RS. Skin CancerAwareness and Sun Protection Behaviors inWhite Hispanicand Non-White Hispanic High School Students in Miami,Florida. Arch of Dermatol. 2007;143(8):983-88.15. Del Carmen M, Findley M, Muzikansky A, et al.Demographic, Risk Factor, and Knowledge DifferencesBetween Latinas and Non-Latinas Referred to Colposcopy.Gynecol Oncol. 2007(1);104:70-76.16. Ramirez AG,Wildes K, Talavera G, Nápoles-Springer A,Gallion K, Pérez-Stable EJ. Clinical Trials Attitudes andPractices of Latino Physicians. Contemp Clin Trials. 2008Jul;29(4):482-92.17. Jacobs EA, Karavolos K, Rathouz PJ, Ferris TG, Powell LH.Limited English Proficiency and Breast and Cervical CancerScreening in a Multiethnic Population. Am J of PublicHealth. 2005;95(8):1410-16.18. Aldridge ML, Daniels JL, Jukic AM. Mammograms andHealthcare Access Among US Hispanic and Non-HispanicWomen 40 Years and Older. Fam Community Health.2006;29(2):80-88.19. Lantz PM, Mujahid M, Schwartz K, et al. The Influence ofRace, Ethnicity, and Individual Socioeconomic Factors onBreast Cancer Stage at Diagnosis. Am J Public Health.2006;96(12):2173-78.20. Kahn JA, Lan D, Kahn RS. Sociodemographic FactorsAssociated with High-Risk Human PapillomavirusInfection. Obstet Gynecol. 2007;110(1):87-95.

Cancer Facts: Hispanic/Latinos and Cancer

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Cancer Facts: Hispanic/Latinos and Cancer

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