He Yuelin, Pinheiro Paulo S, Tripathi Osika, Nguyen Helen, Srinivasan Malathi, Palaniappan Latha P, Thompson Caroline A
Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, California.
Cancer Epidemiol Biomarkers Prev. 2024 Dec 2;33(12):1598-1609. doi: 10.1158/1055-9965.EPI-24-0792.
The Hispanic population is the second largest racial/ethnic group in the United States, consisting of multiple distinct ethnicities. Ethnicity-specific variations in cancer mortality may be attributed to countries of birth, so we aimed to understand differences in cancer mortality among disaggregated Hispanics by nativity (native- or foreign-born vs. US-born) over 15 years.
A total of 228,197 Hispanic decedents (Mexican, Puerto Rican, Cuban, and Central or South American) with cancer-related deaths from US death certificates (2003-2017) were analyzed. Seven cancers that contribute significantly to Hispanic male (lung and bronchus, colon and rectum, liver, prostate, and pancreas cancers) and female (lung and bronchus, liver, pancreas, colon and rectum, female breast, and ovary cancers) mortality were selected for analysis. 5-year age-adjusted mortality rates [(95% confidence interval); per 100,000] and standardized mortality ratios (95% confidence interval) using foreign-born as the reference group were calculated. Joinpoint regression analysis was used to model cancer-related mortality trends.
Puerto Rico-born Puerto Ricans, Cuba-born Cubans, and US-born Mexicans had some of the highest cancer death rates among all the Hispanic groups. In general, foreign-born Hispanics had higher cancer mortality rates than US-born Hispanics, except Mexicans. Overall, US-born and non-US-born (i.e., native- or foreign-born) Hispanic groups experienced decreasing rates of cancer deaths over the years.
We noted vast heterogeneity in mortality rates by nativity across Hispanic groups, a fast-growing diverse US population.
Understanding disaggregated patterns and trends in cancer burden can motivate deeper discussion around community health resources, which may improve the health of Hispanics across the United States.
西班牙裔人口是美国第二大种族/族裔群体，由多个不同的族群组成。癌症死亡率的族群特异性差异可能归因于出生国，因此我们旨在了解15年来按出生地（本土出生或外国出生与美国出生）分类的西班牙裔人群在癌症死亡率方面的差异。
分析了228197名有癌症相关死亡记录的西班牙裔死者（墨西哥裔、波多黎各裔、古巴裔以及中美洲或南美洲裔），这些数据来自美国死亡证明（2003 - 2017年）。选取了对西班牙裔男性（肺癌和支气管癌、结肠癌和直肠癌、肝癌、前列腺癌和胰腺癌）和女性（肺癌和支气管癌、肝癌、胰腺癌、结肠癌和直肠癌、女性乳腺癌和卵巢癌）死亡率有显著影响的七种癌症进行分析。计算了5年年龄调整死亡率[（95%置信区间）；每10万人]以及以外国出生人群为参照组的标准化死亡率（95%置信区间）。采用连接点回归分析对癌症相关死亡率趋势进行建模。
出生在波多黎各的波多黎各人、出生在古巴的古巴人以及在美国出生的墨西哥人在所有西班牙裔群体中癌症死亡率最高。总体而言，除墨西哥人外，外国出生的西班牙裔癌症死亡率高于美国出生的西班牙裔。总体来看，美国出生和非美国出生（即本土出生或外国出生）的西班牙裔群体多年来癌症死亡率均呈下降趋势。
我们注意到，在快速增长且多样化的美国人口中，西班牙裔群体按出生地划分的死亡率存在巨大差异。
了解癌症负担的分类模式和趋势可以推动围绕社区卫生资源展开更深入的讨论，这可能会改善美国各地西班牙裔的健康状况。
