• Posted July 3, 2023

Certain Cancers on the Rise Among Hispanic Americans

Cancer death rates among Hispanic Americans have declined in general over the past two decades, but for certain cancers the outlook has only gotten worse, a new study finds.

First, the good news: Thanks to improvements in screening, diagnosis and treatment -- and a decline in smoking -- the U.S. cancer death rate has been dropping for years. And the new study found that this is true of Hispanic Americans, too.

Unfortunately, deaths from certain cancers are ging in the opposite direction: Between 1999 and 2020, the study found, deaths from liver cancer rose among Hispanic-American men and women, while women saw an increase in deaths from pancreatic and uterine cancers.

Also worrisome, cancer deaths rose among Hispanic men under 35 -- an age when most people probably do not give the possibility of cancer a thought, experts pointed out.

"That was a very striking finding," said senior researcher Dr. Sophia Kamran, a radiation oncologist at Mass General Cancer Center in Boston.

"When we took a deeper dive into it, two cancers stood out," she said.

Those were testicular cancer and colon cancer, which together seemed to be driving the rising death rate among young Hispanic men.

Testicular cancer is very treatable, with high cure rates. But survival rates are relatively lower once it has spread to other sites in the body.

Colon cancer, meanwhile, may be viewed as a disease of older adults, but it has been on the rise among younger Americans in recent years. And that, Kamran said, may be one reason for the rising death rate among young Hispanic men.

But access to health care is likely another big factor, she said. Young adults, especially men, often do not have a regular doctor, and when potential signs of colon cancer arise -- like rectal bleeding -- they may not have them checked out.

That, Kamran said, may be a particular issue for young Hispanic adults: Across age groups, Hispanic Americans face more obstacles accessing health care, including a lack of health insurance, a higher poverty rate and language barriers.

Compared with white Americans, Hispanic Americans do generally have lower rates of common cancers like breast, prostate and lung cancers. But their rates of some other cancers -- including liver, stomach and cervical cancers -- are higher.

And while heart disease is the No. 1 killer of Americans overall, cancer is the leading cause of death among Hispanic Americans -- accounting for 20% of deaths, according to the American Cancer Society (ACS).

That, Kamran said, raises important questions: How often are Hispanic Americans with cancer being diagnosed at later stages, or not receiving optimal treatments?

The new study does not answer those questions, she said. But it gives insights into broad patterns, including the specific types of cancer where deaths are rising.

"Doctors can at least be aware of that," Kamran said.

The findings -- published June 29 in JAMA Oncology -- are based on a federal public health database. Between 1999 and 2020, more than 690,000 Americans of Hispanic ethnicity died of cancer.

Overall, the yearly cancer death rate dipped over time -- by 1.3% per year. But for certain cancers, things went in the wrong direction: Deaths from liver cancer rose by 1% per year, and among women, deaths from pancreatic and uterine cancers climbed by 0.2% and 1.6% per year, respectively.

Among Hispanic men ages 25 to 34, cancer deaths rose by 0.7% per year -- likely due to testicular and colon cancers.

"It's distressing to see that, because we don't have screening for colorectal cancer at that age," said Jane Figueiredo, an associate professor of medicine at Cedars-Sinai Medical Center in Los Angeles.

Figueiredo, who was not involved in the research, is leading a study of colon cancer prevention and treatment among Hispanic Americans.

She said that Americans' death rates from colon cancer are on the decline, but the improvement has been slower for Hispanic Americans.

Disparities in screening and diagnosis may be one reason: According to the ACS, Hispanic Americans have lower screening rates than their white counterparts, and studies have found that Latinos are more likely to receive a later-stage diagnosis.

It's not yet clear why colon cancer is rising among younger Americans generally, Figueiredo said. But since routine screening is not recommended until age 45, she said it's critical that younger people know the possible signs of the disease -- like blood in the stool and sustained changes in bowel movements -- and see a doctor if they arise.

There are clearly issues that require systemic changes, both researchers said -- like improving Hispanic Americans' access to health care, and including more Hispanic people in clinical trials testing cancer therapies.

But doctors can also help educate patients, they said, on the fact that young people can develop colon cancer or how to do a self-exam for testicular cancer, for example.

Kamran also pointed to the biggest success story in the findings: Deaths from lung cancer showed the sharpest drop, falling by about 4% each year.

That's likely due to new treatments, she said, as well as a decline in smoking.

More information

The American Cancer Society has more on cancer among Hispanic Americans.

SOURCES: Sophia Kamran, MD, radiation oncologist, Mass General Cancer Center, assistant professor, radiation oncology, Harvard Medical School, Boston; Jane Figueiredo, PhD, MSc, director, community and population health research, associate professor, medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles; JAMA Oncology, June 29, 2023, online