Senior Associate Scientist, Surveillance and Health Services Research, Intramural Research, American Cancer Society, Atlanta, GA.
Professor, Epidemiology and Biostatistics, University of Puerto Rico School of Public Health, San Juan, PR.
CA Cancer J Clin. 2018 Nov;68(6):425-445. doi: 10.3322/caac.21494. Epub 2018 Oct 4.
Cancer is the leading cause of death among Hispanics/Latinos, who represent the largest racial/ethnic minority group in the United States, accounting for 17.8% (57.5 million) of the total population in the continental United States and Hawaii in 2016. In addition, more than 3 million Hispanic Americans live in the US territory of Puerto Rico. Every 3 years, the American Cancer Society reports on cancer occurrence, risk factors, and screening for Hispanics in the United States based on data from the National Cancer Institute, the North American Association of Central Cancer Registries, and the Centers for Disease Control and Prevention. For the first time, contemporary incidence and mortality rates for Puerto Rico, which has a 99% Hispanic population, are also presented. 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. For all cancers combined, Hispanics have 25% lower incidence and 30% lower mortality compared with non-Hispanic whites, although rates of infection-related cancers, such as liver, are up to twice as high in Hispanics. However, these aggregated data mask substantial heterogeneity within the Hispanic population because of variable cancer risk, as exemplified by the substantial differences in the cancer burden between island Puerto Ricans and other US Hispanics. For example, during 2011 to 2015, prostate cancer incidence rates in Puerto Rico (146.6 per 100,000) were 60% higher than those in other US Hispanics combined (91.6 per 100,000) and 44% higher than those in non-Hispanic whites (101.7 per 100,000). Prostate cancer is also the leading cause of cancer death among men in Puerto Rico, accounting for nearly 1 in 6 cancer deaths during 2011-2015, whereas lung cancer is the leading cause of cancer death among other US Hispanic men combined. Variations in cancer risk are driven by differences in exposure to cancer-causing infectious agents and behavioral risk factors as well as the prevalence of screening. 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.
癌症是西班牙裔/拉丁裔人群的主要死因，他们是美国最大的种族/族裔少数群体，占 2016 年美国大陆和夏威夷总人口的 17.8%（5750 万人）。此外，有超过 300 万的西班牙裔美国人居住在美国波多黎各领土。每三年，美国癌症协会根据美国国家癌症研究所、北美癌症登记中心协会和疾病控制与预防中心的数据，报告美国西班牙裔人群的癌症发病情况、风险因素和筛查情况。这是首次报告人口 99%为西班牙裔的波多黎各的当代发病率和死亡率数据。估计 2018 年在美国大陆和夏威夷的西班牙裔中，将有 149100 例新的癌症病例和 42700 例癌症死亡。总体而言，与非西班牙裔白人相比，西班牙裔的癌症发病率低 25%，死亡率低 30%，尽管与感染相关的癌症（如肝癌）的发病率在西班牙裔中高达两倍。然而，由于癌症风险的变化，这些汇总数据掩盖了西班牙裔人群内部的巨大异质性，例如波多黎各岛民和其他美国西班牙裔之间癌症负担的显著差异。例如，在 2011 年至 2015 年期间，波多黎各的前列腺癌发病率（每 10 万人 146.6 例）比其他美国西班牙裔的发病率（每 10 万人 91.6 例）高 60%，比非西班牙裔白人（每 10 万人 101.7 例）高 44%。前列腺癌也是波多黎各男性癌症死亡的主要原因，在 2011 年至 2015 年期间，占癌症死亡人数的近 1/6，而肺癌是其他美国西班牙裔男性癌症死亡的主要原因。癌症风险的差异是由致癌感染因子和行为风险因素暴露的差异以及筛查的普及程度驱动的。降低西班牙裔人群癌症风险的策略包括针对特定人群、文化适宜的干预措施，以增加预防性服务的利用率并降低癌症风险因素的流行率，以及为波多黎各特有的和亚组特有的癌症研究和监测提供额外资金。
