Hispanic Cancer Incidence And
Mortality Rates, New Jersey, 1990-1996
Table 1 and Table 3 present the age-adjusted incidence rates and mortality rates, respectively, in New Jersey by gender and race/ethnicity for the combined years 1990 through 1996. Annual trends in these rates are presented graphically in Figures 1-4 and are discussed in a separate section below. Because Hispanics can be of any race, there is overlap between Hispanics and blacks. At the time this report was being planned, accurate age- and year-specific data was not available for non-Hispanic blacks. The tables show age-adjusted rates per 100,000 population for over 60 major types of cancer and for all cancer sites combined for Hispanics, non-Hispanic whites, and all blacks. In the following paragraphs, we review major patterns by gender, race, and ethnicity.
Overall Incidence Rates
The incidence rates for all sites combined show that, overall, Hispanic males and females have lower incidence rates than either non-Hispanic whites or blacks. Among males, blacks have the highest rates, whereas among females, non-Hispanic whites have the highest rates. For each race and ethnic group, males have higher incidence rates than females. This table also shows that cervical, stomach, gallbladder and liver cancer are higher in Hispanics than non-Hispanic whites in NJ. This pattern has been seen elsewhere in the US and is discussed in more detail in a later section.
The Five Most Frequently Diagnosed Cancers
Table 2 shows that the five most common cancers are very consistent across race and ethnic group. Among males, prostate, lung and colon cancer are ranked first, second and third in each group. Bladder cancer is one of the top five cancers diagnosed among Hispanic and non-Hispanic white males.
Among females, breast cancer is the most commonly diagnosed cancer across all race and ethnic groups (see Table 2). Colon cancer surpasses lung cancer for Hispanic females, while the order is reversed for non-Hispanic whites and blacks. Cancer of the cervix is the next most common cancer in the two minority populations.
In Appendix I we discuss the major risk factors and preventive measures available for the most commonly diagnosed cancers for men and women (colorectal, lung, breast and prostate cancers).
Cancers with Disproportionately High Incidence among Hispanics
There are some cancer sites for which Hispanic incidence rates are higher than other racial and ethnic subgroups. Cervical, stomach, gallbladder and liver cancer have been most consistently identified in international, national and state publications as being higher among Hispanics compared with non-Hispanic whites. For these sites and a few others mentioned below, the NJSCR data are consistent with national and other states' data, as well as data presented in the literature on Hispanic cancer incidence.15-20
In New Jersey, Hispanic males and females have higher incidence rates for stomach, liver, gallbladder, and certain skin cancers (primarily Kaposi's sarcoma) than non-Hispanic whites. For Hispanic males, rates are higher for cancer of the nasopharynx and penis than non-Hispanic whites. Hispanic females have higher incidence rates for cancer of the nasopharynx, cervix, multiple myeloma, lymphocytic leukemias, and myeloid leukemias than non-Hispanic white females. Blacks also have higher incidence rates than Hispanics for most of the above cancers.
In Appendix II, we discuss the major risk factors and preventive measures for cervical, stomach, gallbladder, and liver cancers.
Cancer Mortality Rates By Race and Ethnicity in New Jersey, 1990-1996
Information on deaths from all causes is processed by the Center for Health Statistics in the New Jersey Department of Health and Senior Services. Cancer mortality data are not reviewed by the same procedures as the cancer incidence data and the smaller numbers of deaths (compared with total cancer cases) result in relatively less stable rates.
Table 3 presents the numbers of deaths and the age-adjusted mortality rates by gender, race and ethnicity among New Jersey residents, 1990-1996. This table presents the same cancer sites shown for the cancer incidence rates in Table 1.
Total Cancer Mortality Rates
For total cancer mortality and for most sites, rates were lowest for Hispanic males and females. The overall ratio of Hispanic to non-Hispanic mortality rates was lower than the corresponding ratio of incidence rates, i.e. there are relatively fewer Hispanic deaths compared with non-Hispanic deaths than for the incidence data. One possible explanation for this pattern is that Hispanic cancer patients may migrate out of New Jersey (possibly to the country of origin) after diagnosis but prior to death.
The Five Most Common Types of Cancer Deaths
As seen in Table 4, lung cancer is the leading cause of cancer death among males in every race and ethnic group followed by prostate and colon cancers. For Hispanic and black males, stomach cancer is among the five most common causes of cancer death.
For Hispanic females (Table 4), breast cancer is the leading cause of cancer mortality, while for non-Hispanic white and black females lung cancer is the leading cause of cancer mortality. Breast, lung, colon and pancreatic cancers appear among the five leading causes of cancer death for females in all race and ethnic groups.
Cancer Types with Disproportionately High Mortality among Hispanics
There are some cancer sites for which Hispanic mortality rates differ from the general pattern of rates for blacks and non-Hispanic whites. The NJSCR data are generally consistent with other states' data and with the published literature on Hispanic cancer mortality for these sites.18,23,24
Specifically, for Hispanic males and females, cancer mortality rates are higher for stomach, liver, and gallbladder cancer than for non-Hispanic whites. For Hispanic males, mortality rates are higher for cancer of the buccal cavity and pharynx (particularly cancers of the tongue and floor of mouth), nasal cavity, and bones/joints. Hispanic females have higher cancer mortality rates for cancer of the cervix and Hodgkin's disease.