Although overall cancer mortality has fallen for the Latino/Hispanic population in the United States, largely thanks to a substantial decline in lung cancer mortality, death rates for certain cancers are on the rise, according to study findings published in JAMA Oncology.
While overall cancer mortality has declined in the United States due to advances in research and better access to treatment, cancer is still the predominant cause of death for Latino people. Sophia Kamran, MD, of Massachusetts General Cancer Center, and colleagues analyzed trends in cancer mortality among Latinos in the United States from 1999 to 2020.
“Despite the great strides in cancer screening, education and treatment advances, there are populations in the U.S. that haven’t benefited from these improvements equally,” Kamran said in a news release. “Cancer incidence is fairly low among Hispanic populations, but it is the leading cause of death….We have to think a little bit differently and target specific cancer research, education and treatments toward this population, so we are caring for these patients as best we can.”
For this cross-sectional study, the researchers used data from the Centers for Disease Control and Prevention WONDER database. The database, maintained by the National Center for Health Statistics, includes the cause of all U.S. deaths according to death certificates.
The researchers accessed data on cancer death rates for all racial and ethnic groups for the years 2000, 2010 and 2020. They assessed trends and average annual percent changes in age-adjusted cancer-specific mortality rates for the Latino population according to sex, age, cancer type and geographical region.
A total of 12,644,869 people died of cancer in the United States from 1999 to 2020. Of these, 690,677 (5.5%) were Latino, 0.5% were American Indian or Alaska Native, 2.4% were Asian or Pacific Islander, 11.4% were non-Hispanic Black or African American and 80.1% were non-Hispanic white. (Some 0.2% of people had an unrecorded ethnicity.)
In 2020, Latino men and women had the second highest mortality rates compared with other racial and ethnic groups for several types of cancer, the study authors reported.
Across all cancer types, the cancer mortality rate decreased by 1.3% annually among Latinos, with a greater decline seen for men (-1.6%) compared with women (-1.0%). The largest decrease was seen in lung cancer deaths (-4.6% for men and -3.6% for women).
“This might be pointing to the fact that there’s been a lot of education about smoking cessation and improvement in screening and treatment for this cancer,” Kamran said.
But when analyzing death rates for specific types of cancer types, the researchers saw some significant differences. For instance, the mortality rate for liver cancer rose by 1.0% among both Latino men and Latino women. Liver cancer deaths rose most among those ages 55 to 64 (+2.1%). Latina women also had increased mortality due to pancreatic cancer and uterine cancer (+0.2% and +1.6%, respectively).
When looking at differences on the basis of age, the researchers found that Latino men between ages 25 and 34 experienced a 0.7% annual increase in overall cancer mortality. The researchers suggested this might be attributable to increasing mortality from colorectal cancer and testicular cancer.
“This finding was pretty striking and may be driving the increase in overall cancer-specific mortality in this particular age group,” Kamran said. “There could be a lack of awareness, education and screening since there is a stigma associated with testicular cancer. And we know colorectal cancer mortality is increasing among younger populations in general.”
The rise in liver cancer mortality for Latino people was notably higher in the West than in the rest of the country. In the West, the annual mortality increase was +1.6% for Latino men and +1.5% for Latina women.
Elevated liver cancer mortality in the Latino population may be associated with a higher prevalence of risk factors, such as hepatitis B, hepatitis C and heavy alcohol consumption, the study authors suggested.
“Our findings of differential gains of improved cancer mortality rates within the Hispanic community suggest that systemic health care inequities have likely contributed to these disparities, leading to decreased access to care, nonadherence to treatment and poor care continuity,” the study authors wrote. This population has a disproportionate poverty rate and barriers to care, including lack of health insurance, but “Hispanic patients are more likely to be diagnosed at advanced cancer stages, leading to worse survival rates, even after controlling for socioeconomic status,” they noted. What’s more, this and other minority populations are underrepresented in cancer clinical trials.
“The observed disparities in cancer mortality may be associated with increases in cancer incidence, financial and cultural barriers to health care, lack of cancer screenings and diagnosis at advanced stages of the disease,” the researchers concluded. “Future studies are needed to implement sustainable solutions to reverse these trends in the growing U.S. Hispanic population.”
Click here to read the study abstract in JAMA Oncology.
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