Miller Kimberly D, Ortiz Ana P, Pinheiro Paulo S, Bandi Priti, Minihan Adair, Fuchs Hannah E, Martinez Tyson Dinorah, Tortolero-Luna Guillermo, Fedewa Stacey A, Jemal Ahmedin M, Siegel Rebecca L
Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia.
Cancer Control and Population Sciences, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.
CA Cancer J Clin. 2021 Nov;71(6):466-487. doi: 10.3322/caac.21695. Epub 2021 Sep 21.
The Hispanic/Latino population is the second largest racial/ethnic group in the continental United States and Hawaii, accounting for 18% (60.6 million) of the total population. An additional 3 million Hispanic Americans live in Puerto Rico. Every 3 years, the American Cancer Society reports on cancer occurrence, risk factors, and screening for Hispanic individuals in the United States using the most recent population-based data. An estimated 176,600 new cancer cases and 46,500 cancer deaths will occur among Hispanic individuals in the continental United States and Hawaii in 2021. Compared to non-Hispanic Whites (NHWs), Hispanic men and women had 25%-30% lower incidence (2014-2018) and mortality (2015-2019) rates for all cancers combined and lower rates for the most common cancers, although this gap is diminishing. For example, the colorectal cancer (CRC) incidence rate ratio for Hispanic compared with NHW individuals narrowed from 0.75 (95% CI, 0.73-0.78) in 1995 to 0.91 (95% CI, 0.89-0.93) in 2018, reflecting delayed declines in CRC rates among Hispanic individuals in part because of slower uptake of screening. In contrast, Hispanic individuals have higher rates of infection-related cancers, including approximately two-fold higher incidence of liver and stomach cancer. Cervical cancer incidence is 32% higher among Hispanic women in the continental US and Hawaii and 78% higher among women in Puerto Rico compared to NHW women, yet is largely preventable through screening. Less access to care may be similarly reflected in the low prevalence of localized-stage breast cancer among Hispanic women, 59% versus 67% among NHW women. Evidence-based strategies for decreasing the cancer burden among the Hispanic population include the use of culturally appropriate lay health advisors and patient navigators and targeted, community-based intervention programs to facilitate access to screening and promote healthy behaviors. In addition, the impact of the COVID-19 pandemic on cancer trends and disparities in the Hispanic population should be closely monitored.
西班牙裔/拉丁裔人口是美国本土和夏威夷第二大种族/族裔群体，占总人口的18%（6060万）。另外有300万西班牙裔美国人居住在波多黎各。美国癌症协会每3年利用最新的基于人群的数据报告美国西班牙裔人群的癌症发病率、风险因素和筛查情况。2021年，在美国本土和夏威夷的西班牙裔人群中，估计将有176,600例新癌症病例和46,500例癌症死亡。与非西班牙裔白人（NHW）相比，西班牙裔男性和女性所有癌症合并发病率（2014 - 2018年）和死亡率（2015 - 2019年）低25% - 30%，最常见癌症的发病率也较低，不过这种差距正在缩小。例如，西班牙裔与NHW个体相比，结直肠癌（CRC）发病率比值从1995年的0.75（95%CI，0.73 - 0.78）缩小到2018年的0.91（95%CI，0.89 - 0.93），这反映出西班牙裔个体中CRC发病率下降延迟，部分原因是筛查的接受程度较慢。相比之下，西班牙裔个体感染相关癌症的发病率较高，包括肝癌和胃癌的发病率高出约两倍。在美国本土和夏威夷的西班牙裔女性中，宫颈癌发病率比NHW女性高32%，在波多黎各女性中则高78%，不过通过筛查在很大程度上是可以预防的。获得医疗服务的机会较少可能同样反映在西班牙裔女性局部晚期乳腺癌的低患病率上，NHW女性为67%，而西班牙裔女性为59%。减少西班牙裔人群癌症负担的循证策略包括使用具有文化适宜性的外行人健康顾问和患者导航员，以及有针对性的、基于社区的干预项目，以促进获得筛查服务并促进健康行为。此外，应密切监测2019冠状病毒病大流行对西班牙裔人群癌症趋势和差异的影响。
