Cancer has the dubious distinction of being the leading cause of death among Hispanics in the U.S., surpassing heart disease.
In a report released Monday, the American Cancer Society announced that although cancer death rates are falling slightly among Hispanics, for the first time, cancer deaths have surpassed deaths from heart disease in this group. The statistics are from 2009, the most recent year for which data is available.
Among Hispanics, 21.1 percent of deaths are due to cancer while 20.9 percent of deaths can be attributed to heart disease, according to the report, published in CA: A Cancer Journal for Clinicians. Among non-Hispanic whites, one-quarter of deaths are due to heart disease, while cancer deaths rank second at 23.5 percent.
The emergence of cancer as the leading cause of death among Hispanics is a gauge for the rest of the country. Eventually, cancer will become the leading cause of death among all Americans, Rebecca Siegel, an epidemiologist with the American Cancer Society and co-author of the study, told Take Part. Heart disease still ranks first among whites because the average age of whites is much older than Hispanics.
"The number of deaths from cancer will overtake deaths from heart diseases in the overall population in the near future," she explains. "Cancer is the leading cause of death among individuals younger than 85 in the overall population. We are seeing this crossover earlier among Hispanics because of a demographic difference—Hispanics are a much younger population."
But the pattern of cancer among Hispanics differs greatly from whites, a finding that has major implications for public health officials who plan programs to reduce cancer deaths. The report found that Hispanics have lower incidence and death rates of cancers of the breast, prostate, lung and colon compared to non-Hispanic whites. The risk of lung cancer among Hispanics is about half that of whites, for example, because smoking rates are lower.
However, Hispanics have higher incidence and death rates for cancers of the stomach, liver, gallbladder and uterus and cervix. These types of cancer are more likely to be caused by infections that people contract in the country they came from, but they usually fall ill after immigrating to the United States, Siegel says.
"New Hispanic immigrants bring with them the cancer risk of their home country, which is typically much different from the risk among non-Hispanic whites," she says. "The proportion of new cancer associated with infectious agents in Latin America is four times that in North America because the infections that cause these cancers are more common in the low- and middle-income countries such as Mexico and those in Central and South America from Hispanics emigrate."
Human papilloma virus infection accounts for most cases of cervical cancers. The Helicobacter pylori virus is linked to a higher risk of stomach cancer, and the hepatitis B virus can lead to liver cancer.
But lifestyle plays a role in the differences between ethnic groups, she notes.
"Hispanic women have lower rates of breast cancer than non-Hispanic whites because they tend to have reproductive patterns that are more protective against breast cancer, such as earlier age at first birth, more children and an increased likelihood to breast-feed," Siegel says.
However, as immigrants become acculturated, the differences tend to fade. For example, she says, the longer a Hispanic woman has lived in the U.S., the more her risk of breast cancer increases.
Other differences in cancer death rates have more to do with poverty and access to healthcare, Siegel says. In 2010, more than 26 percent of Hispanics lived in poverty and just over 30 percent were uninsured, compared to 9.9 percent of whites who live in poverty and 11.7 percent who are uninsured.
Preventing cancer deaths among Hispanics will be challenging because of wide cultural and genetic differences among Hispanics. Fifty million Americans—about 16 percent of the population—identify themselves as Hispanic or Latino. While the majority of Hispanics living in the United States are Mexican, others are from Puerto Rico, Central America, South America or Cuba, according to the American Cancer Society.
In Florida, the study notes, cancer death rates for Cuban men are double that of Mexican men because Cuban men are more likely to smoke. Obesity, a risk factor for several types of cancer, is much higher in Mexican and Puerto Rican men than among Dominican men.
Reducing cancer deaths among Hispanics will come down to community efforts, Siegel says.
"Cancer occurrence information has generally been reported for Hispanics in aggregate, masking the substantial differences and making it difficult to establish more targeted interventions," she says. "However, information is becoming increasingly more available about Hispanic populations by country of origin, so cancer control efforts should zero in on the needs of these subpopulations as much as possible."
Question: What can individual communities do to help prevent cancer? Tell us what you think in the comments.