Cancer Facts & Figures for Hispanics/Latinos

2015-2017

Contents Overview

1

Major Cancer Sites

8

Cancer Sites with Higher Rates among Hispanics

10

Cancer in Children and Adolescents

13

Risk Factors for Cancer

16

Cancer Screening

24

Factors That Influence Health: Socioeconomic Status and Cultural Values and Beliefs

27

How the American Cancer Society Helps Reduce Cancer Disparities

29

Additional Resources

32

Factors That Influence Cancer Rates

32

Sources of Statistics

33

References

35

Acknowledgments The production of this report would not be possible without the efforts of Ermilo Barrera, MD; Tracie Bertaut, APR; Stacey Fedewa, MPH; Trista Hargrove, MA; Melissa Maitin-Shepard, MPP; Catherine McMahon, MPH; Anthony Piercy; Paulo Pinheiro, MD, PhD; Ann Goding Sauer, MSPH; Scott Simpson; Termika Smith, ED.D; Lindsey Torre, MSPH; Ed Trapido, ScD; Dinorah Martinez Tyson, PhD, MPH, MA; and Dana Wagner. Cancer Facts & Figures for Hispanics/Latinos is a publication of the American Cancer Society, Atlanta, Georgia.

For more information, contact: Rebecca Siegel, MPH Kimberly Miller, MPH Ahmedin Jemal, PhD Surveillance & Health Services Research

Corporate Center: American Cancer Society Inc. 250 Williams Street, NW, Atlanta, GA 30303-1002 (404) 320-3333 ©2015, American Cancer Society, Inc. All rights reserved, including the right to reproduce this publication or portions thereof in any form. For written permission, address the Legal department of the American Cancer Society, 250 Williams Street, NW, Atlanta, GA 30303-1002.

This publication attempts to summarize current scientific information about cancer. Except when specified, it does not represent the official policy of the American Cancer Society. Suggested citation: American Cancer Society. Cancer Facts & Figures for Hispanics/Latinos 2015-2017. Atlanta: American Cancer Society; 2015.

Overview Introduction According to estimates from the US Census Bureau, 55 million Americans, or 17% of the total US population, identified as Hispanic or Latino in 2014.1 The terms “Hispanic” and “Latino/a” are used to refer to a person of Hispanic origin. The word Hispanic is a socially and politically constructed US federal designation used in national and state reporting systems that is a separate concept from race; as such, persons of Hispanic origin may be of any race. Latino/a is a self-designated term of ethnicity. In this document, Hispanic and Latino/a are used interchangeably without preference or prejudice. Hispanics are the largest and youngest minority group in the United States. Between 2000 and 2014 the Hispanic population grew by 57%, more than four times the growth of the total population.1, 2 In recent years, the growth of the Hispanic population in the US has been driven more by births than by immigration.3 From 2011 to 2013, 28% of the Hispanic population was younger than 15 years of age, compared to 16% of non-Hispanic whites.4 More than one-third (35%) of Hispanics in the US are foreign born (i.e., born outside the US and its territories, including

Puerto Rico). The majority of US Hispanics are of Mexican origin (64.3%), followed by Puerto Rican (9.5%), Salvadoran (3.7%), Cuban (3.7%), and Dominican (3.1%). The Hispanic population is not equally distributed across the US, but is concentrated in the West (40%) and South (37%) (Figure 1).5 More than half of all Hispanics live in the three states of California (27%), Texas (19%), and Florida (9%). Among states there is substantial variation in the Hispanic population by country of origin. For example, Mexicans comprise more than 80% of the Hispanic population in both Texas and California, compared to only 15% in Florida.4 This report summarizes statistics on cancer incidence, mortality, survival, risk factors, and early detection and screening for Hispanics in the US. It is intended to provide information to community leaders, public health and health care workers, and others interested in cancer prevention, early detection, and treatment for Hispanics. It is important to note that most cancer data in the US are reported for Hispanics as an aggregate group, masking important differences between Hispanic subpopulations according to nativity status (i.e., those who are foreign born versus those who are US born), degree of acculturation, and country of origin. For example, one study found that US cancer death rates in Mexicans are 12% lower than those in mainland Puerto Ricans.6

Figure 1. Hispanic Population Distribution as a Percent of Total County Population

Percent More than 50.0 25.0 to 50.0 17.1 to 24.9 5.0 to 17.0 Less than 5.0

Source: US Census Bureau, Population Estimates, July 2013. Released 2014.

Cancer Facts & Figures for Hispanics/Latinos 2015-2017  1

What Is Cancer? Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. If the spread is not controlled, it can result in death. Cancer is caused by external factors, such as tobacco, infectious organisms, and an unhealthy diet, and internal factors, such as inherited genetic mutations, hormones, and immune conditions. These factors may act together or in sequence to cause cancer. Ten or more years often pass between exposure to external factors and detectable cancer. Cancer is treated with surgery, radiation, chemotherapy, hormone therapy, immune therapy, and targeted therapy (drugs that specifically target cancer cells to prevent growth).

Can Cancer Be Prevented? A substantial proportion of cancers could be prevented with the adoption of healthier lifestyles, including not smoking, maintaining a healthy body weight, eating a healthy diet, protecting skin from excessive sun exposure, and being physically active. All cancers caused by tobacco and heavy alcohol consumption could be prevented completely. Many of the cancers caused by infectious organisms are also avoidable, either by preventing the infection through behavioral changes or vaccination, or by treating the infection. For more information on cancer risk factors, see page 16. Screening can help prevent colorectal and cervical cancers through the detection and removal of precancerous growths. Screening can also help detect cancers of the breast, colorectum,

cervix, and lung (among long-term and/or heavy smokers) at an early stage, when treatment is more likely to be successful. For more information on cancer screening, see page 24.

What Is the Risk of Developing or Dying of Cancer? The risk of being diagnosed with cancer increases with age because most cancers require many years to develop (Table 1). However, because the Hispanic population is younger than the non-Hispanic white population, a larger proportion of cancers are diagnosed in younger age groups. For example, 25% of cancer diagnoses in Hispanics are in those younger than 50 years of age, compared to only 12% in non-Hispanic whites. Overall, about 1 in 3 Hispanic men and 1 in 3 Hispanic women will be diagnosed with cancer in their lifetime. The lifetime probability of dying from cancer is 1 in 5 for Hispanic men and 1 in 6 for Hispanic women. Cancer is the leading cause of death among Hispanics, accounting for 22% of deaths in 2012 (Table 2).

How Many New Cancer Cases and Deaths Are Expected in 2015? New cases: A  bout 58,400 new cancer cases in Hispanic men and 67,500 cases in Hispanic women are expected to be diagnosed in 2015 (Figure 2). These estimates do not include carcinoma in situ (noninvasive cancer) of any site except urinary bladder. They also exclude basal cell and squamous cell skin cancers, because

Table 1. Probability (%) of Developing Invasive Cancer among Hispanics/Latinos during Selected Age Intervals by Sex, US, 2010-2012* All sites† Breast Colon & rectum Liver & intrahepatic bile duct Lung & bronchus Non-Hodgkin lymphoma Prostate Stomach Thyroid Uterine cervix

Male Female Female Male Female Male Female Male Female Male Female Male Male Female Male Female Female

Birth to 49

50 to 59

60 to 69

70 and Older

Birth to Death

2.6 (1 in 39) 4.4 (1 in 23) 1.5 (1 in 68) 0.3 (1 in 386) 0.2 (1 in 416) 0.1 (1 in 1,009)