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Cancer survival among Latinos and the Hispanic Paradox

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Abstract

Background

Cancer survival is a key indicator of the effectiveness and social justice of health services. However, little is known about cancer survival among Hispanics, how it varies by Hispanic subgroup (Mexicans, Puerto Ricans, Cubans, and Others), and how their survival patterns relate to the Hispanic Paradox.

Methods

We studied all 1.2 million cancer cases diagnosed during 1995–2003, in two states, Florida and Texas, according to three categories of outcome: highly fatal outcome, poor outcome, and moderate outcome. All were followed up until December 31, 2006. We calculated survival rates for each Hispanic subgroup, and using Cox regression, we studied the risk of death for each Hispanic subgroup compared with non-Hispanic Whites, adjusted for age, cancer site, and stage at diagnosis.

Results

Important differences in cancer survival were found according to Hispanic subgroup. For cancers of moderate outcome, the adjusted risk of death was higher among all Hispanic populations in comparison with non-Hispanic Whites: 6% higher for Cubans, 11% for Puerto Ricans, and 13% for US-born Mexicans. Foreign-born Mexicans, even with incomplete follow-up, had a 24% higher risk of death. For foreign-born Hispanics, except Cubans, the mortality follow-up of cancers of highly fatal outcome was insufficient, resulting in missing deaths and thus unrealistically high survival rates.

Conclusions

No evidence of a Hispanic advantage was found in cancer survival. Improvement in mortality follow-up procedures for Latinos, especially for those without a valid social security number, is critical. By considering Hispanics as a whole rather than by subgroup, existing survival disparities are being missed.

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Acknowledgments

Recinda Sherman, Mark Rudolph, Jill MacKinnon, Tara Hylton, Tulay Sengul. The Florida cancer incidence data used in this article were collected by the Florida Cancer Data system under contract with the Florida Department of Health. The views expressed herein are solely those of the author(s), and do not necessarily reflect those of the contractor of the Florida Department of Health.

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Authors and Affiliations

  1. School of Community Health Sciences, University of Nevada Las Vegas, BHS 359, S Maryland Parkway, Box 490693, Las Vegas, NV, 89154, USA

    Paulo S. Pinheiro & Sheniz Moonie

  2. Department of State Health Services Texas, Texas Cancer Registry, Austin, TX, USA

    Melanie Williams, Eric A. Miller & Stephanie Easterday

  3. Louisiana State University Health Sciences Center, New Orleans, LA, USA

    Edward J. Trapido

Authors
  1. Paulo S. Pinheiro
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  2. Melanie Williams
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  3. Eric A. Miller
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  4. Stephanie Easterday
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  5. Sheniz Moonie
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  6. Edward J. Trapido
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Correspondence to Paulo S. Pinheiro.

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Pinheiro, P.S., Williams, M., Miller, E.A. et al. Cancer survival among Latinos and the Hispanic Paradox. Cancer Causes Control 22, 553–561 (2011). https://doi.org/10.1007/s10552-011-9727-6

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  • DOI: https://doi.org/10.1007/s10552-011-9727-6

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