Large Disparities in Cancer Mortality Rates Found Among Different Racial/Ethnic Populations in New York State
According to the American Cancer Society, cancer is the leading cause of death for Hispanics and Asian/Pacific Islanders in the United States. However, their cancer burden is less than that of non-Hispanic whites and especially non-Hispanic blacks, who bear the most disproportionate share of the cancer burden. To capture the diversity of cancer patterns between Hispanic, non-Hispanic whites, non-Hispanic blacks, and Asian populations, as well as specific Hispanic and non-Hispanic black subgroups, including Puerto Rican, Dominican, South American, Central American, U.S.-born black, and Caribbean-born black, Pinheiro et al analyzed mortality data from the highly populated and racially and ethnically diverse state of New York. Their findings were published in Cancer Epidemiology, Biomarkers & Prevention.
The researchers found high rates of cancer mortality among U.S.-born blacks and Puerto Ricans and relatively low cancer mortality rates among Hispanic South Americans and Asians. In addition, compared to Caribbean-born blacks, U.S.-born blacks had nearly five-times higher mortality rates for lung cancer, three-times higher mortality rates for liver cancer (in males)—a cancer that disproportionately impacts minority groups—and two-times higher mortality rates for colorectal cancer (in males) and pancreatic, kidney, and bladder cancers.
Study Methodology
The researchers analyzed data on 244,238 cancer-related deaths from 2008–2014 obtained from the New York State Department of Health. Mortality rates and regression-derived ratios with corresponding 95% confidence intervals (CIs) were computed to compare Hispanic, non-Hispanic white, non-Hispanic black, and Asian populations, as well as specific Hispanic and non-Hispanic black subgroups. Special analyses on liver cancer mortality were also performed.
Study Findings
The researchers found that mortality rates were highest for U.S.-born blacks and lowest for South Americans and Asians. Minority groups had higher mortality from liver and stomach cancer than non-Hispanic whites; Hispanics and non-Hispanic blacks also had higher mortality from cervical and prostate cancers. Excess liver cancer mortality among Puerto Rican and U.S.-born black men was observed, particularly for the 1945–1965 birth cohort, with mortality rate ratios of 4.27 (95% CI = 3.82–4.78) and 3.81 (95% CI = 3.45–4.20), respectively.
Clinical Impact
“When we combine the minority subpopulations into large groups, we don’t see any stark differences in liver cancer mortality,” said lead study author Paulo S. Pinheiro, MD, a cancer epidemiologist at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. “But by disaggregating these minority cohorts, we see a huge risk for liver cancer mortality among Puerto Ricans and U.S-born blacks, and this may reflect a higher rate of HCV [hepatitis C virus] infection among these subpopulations. We need to increase the awareness of patients and clinicians to the higher risk of liver cancer among these groups, so they can get screened for HCV infection as a measure to decrease liver cancer incidence. There’s a disconnect between the target populations in our national programs and the reality of liver cancer risk, especially among Puerto Ricans.”
Funding for this study was provided by the National Institute of General Medical Sciences.
Dr. Pinheiro is the corresponding author of this study.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
