Living in U.S. Raises Cancer Risk for Hispanics

Study Shows Cancer Rates Rise for Hispanics After They Move to U.S.

From the WebMD Archives

Aug. 6, 2009 -- The risk of cancer for Hispanics increases by 40% when they move to the U.S., according to a new study.

The risks of specific cancers, however, differ widely among the Hispanic subgroups of Cubans, Puerto Ricans, and Mexicans, the researchers also found.

On the positive side, U.S. Hispanics generally have lower cancer incidence than non-Hispanic U.S. whites, says Paulo Pinheiro, MD, PhD, a researcher in the department of epidemiology and public health at the University of Miami Miller School of Medicine in Florida, who led the study.

"On the negative side, they increase their risk when they come here for the majority of the analyzed [in his study] cancers," Pinheiro tells WebMD. The study is published in Cancer Epidemiology, Biomarkers &Prevention.

For the study, Pinheiro and his colleagues analyzed data from the Florida cancer registry for the years 1999-2001 and the 2000 U.S. Census population data. They also used data from the International Agency for Research on Cancer of the World Health Organization.

It's been known, Pinheiro says, that Hispanics in the U.S. have a generally lower cancer incidence rate than non-Hispanic U.S. whites, especially for breast, colorectal, and lung cancer, but a higher incidence rate for cancers associated with infections and with lower socioeconomic status, such as cervical, liver, and stomach cancers.

But Pinheiro wanted to "unmask" the variation in cancer occurring in the Hispanic subpopulations of Cubans, Mexicans, Puerto Ricans, and others.

"This is the first time we have actually come up with numbers, with cancer rates for each population," he tells WebMD. "Florida is the perfect place to study a wide spectrum [of Hispanic subpopulations]," he says. "All subgroups are represented in sufficient numbers."

In all, nearly 302,000 cancers were diagnosed in Florida residents during the years studied, 1999 to 2001, and that included more than 30,000 Hispanic people, with 68% of them identified to a specific Hispanic subgroup.

Cancer Rates in U.S. vs. Country of Origin

Pinheiro found good and not-so-good news. "The good news is, for all Latinos, [total] cancer incident rates are still lower than for blacks or whites,'' Pinheiro says.

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But cancer risk increases after they come to the U.S., he says, presumably as Hispanics adopt unhealthy U.S. lifestyle habits such as eating fast food too frequently.

Even though many studied were first generation, Hispanics in Florida had at least a 40% increased rate of cancer than Hispanics who lived in their countries of origin, the researchers found.

Then the researchers looked more closely at the subgroups. "Each Latino population has a different cancer profile," Pinheiro says. Among his findings:

  • Puerto Ricans in the study had the highest rates of cancer overall, followed by Cubans and Mexicans.
  • Puerto Ricans in general had cancer rates close to that of whites, with a few exceptions. Lung cancer and melanoma in men and women and breast cancer in women were lower in Puerto Ricans than in whites. But Puerto Ricans had high rates of cervical, stomach, and liver cancer, the same as in Hispanic countries. Puerto Rican men had the highest rates for oral cavity and liver cancers of all the Hispanic populations analyzed.
  • Cubans were comparable with whites in cancer rates, including low rates of cervical and stomach cancers. Cuban men were most afflicted by cancer associated with tobacco, such as lung and larynx, bladder, kidney, and pancreas. Cuban women had the highest rate of colorectal cancer among all women studied.
  • Mexicans had the lowest cancer incidence rate of all the subgroups. They had especially low rates of prostate, breast, endometrial, and colorectal cancers. But they had higher rates of cancers associated with minorities -- such as stomach, cervical, and liver -- than did whites.

Heritage Protects Hispanics

The researchers' finding "confirms some trends we've been seeing in the last few years -- that different U.S. Hispanic populations groups, such as Cubans, Mexicans, and Puerto Ricans, have higher incidence rates of certain cancers than they do in their homelands," says Amelie G. Ramirez, DrPH, director of the Institute for Health Promotion and Research and co-associate director of the Cancer Prevention and Population Studies Research Program at the Cancer Therapy & Research Center (CTRC) at the University of Texas Health Science Center, San Antonio.

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"They also tend to have worse cancer outcomes due to less access to health care and late diagnosis," Ramirez says in a prepared statement.

The study also reflects the reality that Hispanics are not a single ethnic group, but represent several population groups, she says.

Ramirez and Pinheiro agree more research focusing on the Hispanic populations is crucial. About one in three people in the U.S. will be Hispanic by 2050, according to Ramirez. And research is lacking.

Hispanic people who immigrated here, Pinheiro says, should realize that their heritage "can be an advantage if they are able to maintain the protective lifestyle that protects them from cancer."

That probably includes a diet that's not rich in red meat, which has been linked with colorectal cancer, he says, and eating meals prepared at home instead of getting fast food.

Ramirez tells WebMD: "Hispanic patients, no matter what Hispanic population group they belong to, should fully describe their heritage, family history, and health behaviors to their physician or medial professional." That information, she says, will help the health care provider take the patient's background into account to provide the best health care.

WebMD Health News Reviewed by Louise Chang, MD on August 06, 2009

Sources

SOURCES:

Paulo Pinheiro, MD, PhD, researcher, department of epidemiology and public health, University of Miami Miller School of Medicine, Florida.

Pinheiro, P. Cancer Epidemiology, Biomarkers and Prevention, August 2009; vol 18: pp 2162-2169.

Amelia G. Ramirez, DrPH, director, Institute for Health Promotion Research; co-associated director, Cancer Prevention and Population Studies research program, Cancer Therapy & Research Center, University of Texas Health Science Center, San Antonio.

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