Grouping All Hispanic Americans Hides Differences in Cancer Outcomes



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PICTURE

PICTURE: SDSU public health researchers Caroline Thompson and Steven Zamora studied cancer mortality statistics by separating data for each US Hispanic ethnic group.
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Credit: San Diego State University

A study by San Diego State University is among the first to describe trends in Hispanic cancer mortality for the top 10 causes of cancer deaths in the country.

There are subtle and sometimes significant differences in the eating habits, cultural mores and lifestyles of Cubans, Mexicans, Puerto Ricans and Americans in the Central and Southern United States. It also extends to the risks of cancer and death. Yet subgroups tend to be grouped under the broader umbrella of Hispanic Americans, much like Americans of Asian descent, despite the inherent diversity.

National statistics on cancer mortality tell very different stories according to whether Hispanics are grouped or separated according to their ethnic origin. This is particularly true for men belonging to certain Hispanic groups, who had significantly higher differentiated risks than men with similar risks.

The study was conducted because a third-generation graduate researcher at SDSU, Mexican-American, wanted to understand what his own risks were. Steven Zamora undertook a one-year study of cancer mortality rates from the National Center for Health Statistics (NCHS) for the period 2003 to 2012, which led to surprising results for each patient. ethnic group, and cancers of the stomach and liver in particular. .

"I wanted to study something that would have a lasting impact and it was very rewarding personally," said Zamora, who completed his master's degree in public health at the SDSU School of Public Health. "Although Hispanic groups may have similar stories about immigration, they are very different in terms of employment and education opportunities, health outcomes and more. 39, access to care. "

Cancers of the stomach and liver are a major concern

Posted online first to Cancer epidemiology, biomarkers and prevention, a study published by the American Association for Cancer Research, found that Mexican Americans and Puerto Rican Americans died twice as fast as non-Hispanic whites of stomach and liver cancers.

"These are the two most worrying cancers for Hispanic Americans, both of which are caused by chronic infection," said Caroline Thompson, lead author of the study and badistant professor of public health at SDSU.

Puerto Rican men had the highest number of liver cancer deaths with 16 deaths out of 100,000, followed by Americans of Mexican descent at age 14, while non-Hispanic white men were seven. With regard to stomach cancer, mortality rates of American men of Mexican, Mexican, Puerto Rican, Central American and South American origin were eight per cent 000, versus four for non-Hispanic whites. "We also found that liver cancer death rates were increasing among men and women in all Hispanic groups," Thompson said.

Cuban-Americans, on the other hand, tended to reflect the trends of non-Hispanic whites for both cancers, being one of the earliest immigrant groups in the United States much longer than recent immigrants. With better access to health care and better compliance with vaccinations and cancer screening, it seems to have better protected them from infectious disease-related cancers than any other group.

However, lung cancer death rates were higher for Cuban men than for other Hispanic men, at 50 per 100,000, while comparable figures were 67 for non-Hispanic whites, 30 for Mexican men and 15 for Central and South Americans.

Hispanic paradox

The good news is that, with the exception of stomach and liver cancers, Hispanic Americans had better cancer outcomes and lower cancer mortality rates than non-Hispanic whites , results consistent with findings of the American Cancer Society.

"Why do Hispanic Americans have better health outcomes when they have lower socioeconomic status, more limited access to care, and language barriers?" Zamora asked. "It's something we do not know yet, but it's not limited to cancer mortality.There is a health benefit for Hispanics that we can not really explain, but it does not have a lot to do with it. Nor is it equal for all Hispanic groups.This advantage or paradox disappears more than they were in the United States. "

Further studies are needed to determine the relative importance of the many potential and important risk factors for cancer mortality in these specific Hispanic groups. A comprehensive understanding of the burden of cancer is essential to guide treatment and prevention strategies, particularly among Hispanics, as they represent a heterogeneous and growing segment of the US population.

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Funding and collaborations

The study was funded by a grant from the National Institutes of Health's Education Program in Cancer Epidemiology in Special Populations. "This is a program to fund graduate students from underrepresented populations or studying underserved populations, and Steven's project fits both categories," Thompson said.

Co-authors from the Faculty of Medicine at Stanford University, the School of Medicine at the University of California at San Francisco and the University of Miami's Faculty of Medicine also collaborated in the study.

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