Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
J Natl Cancer Inst. 2022 Jul 11;114(7):959-968. doi: 10.1093/jnci/djac078.
Latinos are the largest minority group in the United States. We assessed cancer mortality by birthplace and generation status of Mexican Latinos in the Multiethnic Cohort.
We included 26 751 Latinos of Mexican origin and 6093 non-Latino Whites aged 45-74 years at cohort entry (1993-1996) from the California Multiethnic Cohort component. The Mexican Latinos comprised 42% first-generation Mexico-born immigrants, 42% second-generation (28% US-born with both parents Mexico-born and 14% US-born with 1 parent US-born and 1 parent Mexico-born), and 16% third-generation or more who were US-born with both parents US-born. Multivariable Cox models were used to calculate covariate adjusted hazard ratios and 95% confidence intervals for overall and site-specific cancer mortality by birthplace and generation status. All statistical tests were 2-sided.
Cancer death rate was highest among the US-born with 1 parent US-born and 1 parent Mexico-born (age-adjusted rate = 471.0 per 100 000 person-years) and US-born with both parents US-born (age-adjusted rate = 469.0 per 100 000 person-years) groups. The US-born with both parents Mexico-born group had a 30% (hazard ratio = 1.30, 95% confidence interval = 1.18 to 1.44) higher risk of cancer death than the first-generation Mexico-born immigrants group, showing US birthplace was associated with an elevated cancer mortality. For cancer-specific mortality, US birthplace was positively associated with colorectal, liver and lung, and ovarian cancer (P values ranged from .04 to .005). Among US-born Mexican Latinos, generation status was not statistically significantly associated with overall cancer or site-specific cancer mortality.
Our findings suggest that US birthplace is a risk factor for cancer death in Mexican Americans. Identification of the contributing factors is important to curtail patterns of increasing cancer mortality in US-born Mexican Latinos.
拉丁裔是美国最大的少数族裔群体。我们评估了出生地点和墨西哥裔拉丁裔代际地位对多族裔队列中癌症死亡率的影响。
我们纳入了 26751 名原籍墨西哥的拉丁裔和 6093 名非拉丁裔白人，他们在队列入组时（1993-1996 年）年龄在 45-74 岁之间，来自加利福尼亚多族裔队列。墨西哥裔拉丁裔人群中包括 42%第一代墨西哥出生的移民、42%第二代（28%美国出生，父母均为墨西哥出生，14%美国出生，父母一方为美国出生，一方为墨西哥出生）和 16%第三代或以上的美国出生，父母均为美国出生。采用多变量 Cox 模型计算按出生地和代际地位划分的总体和特定部位癌症死亡率的校正后危险比和 95%置信区间。所有统计检验均为双侧检验。
父母均为美国出生和父母一方为美国出生、一方为墨西哥出生的人群癌症死亡率最高（年龄调整率=每 100000 人年 471.0），父母均为美国出生的人群癌症死亡率第二高（年龄调整率=每 100000 人年 469.0）。父母均为墨西哥出生的人群癌症死亡率比第一代墨西哥出生的移民高 30%（危险比=1.30，95%置信区间=1.18 至 1.44），表明美国出生与癌症死亡率升高相关。特定癌症死亡率方面，美国出生与结直肠癌、肝癌和肺癌以及卵巢癌呈正相关（P 值范围为 0.04 至 0.005）。在出生于美国的墨西哥裔拉丁裔人群中，代际地位与总体癌症或特定部位癌症死亡率无统计学显著相关性。
我们的研究结果表明，美国出生是墨西哥裔美国人癌症死亡的一个危险因素。确定促成因素对于遏制美国出生的墨西哥裔拉丁裔癌症死亡率不断上升的模式非常重要。
