Cancer and US Latinos Daniel Santibanez, MPH, University of North Florida June 24, 2005 - UNF Hispanic Health Issues Seminar This is part 5 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Department.

1. Cancer and U.S. Latinos Daniel Santibanez, MPH Department of Public Health University of North Florida This is part 5 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Department. For more information or register for the seminars, please call 620-1289.

6. Cancer Incidence Rates (Number of new cases each year) Statistics are for 1996-2000, are adjusted for the 2000 U.S. standard million population, and represent the number of new cases of invasive cancer per year per 100,000 of both sexes, males, and females, respectively. 312.2 419.3 352.1 Hispanic/Latino 229.2 259.0 239.6 Amer Indian/ Alaska Native 306.9 392.0 341.7 Asian/Pacific Islander 431.8 555.9 479.8 White 406.3 696.8 521.7 African-American Females Males Both Sexes Group

7. Cancer Death Rates (Number of deaths each year) Statistics are for 1996-2000, are adjusted for the 2000 U.S. standard million population, and represent the number of deaths per year per 100,000 of both sexes, males, and females, respectively. 112.4 176.7 137.9 Hispanic/Latino 102.0 154.8 124.5 Asian/Pacific Islander 115.8 172.3 138.0 Amer Indian/ Alaska Native 166.9 249.5 199.1 White 198.6 356.2 257.1 African-American Females Males Both Sexes Group

9. Hispanic/Latina Females: Death Rates and Incidence for Breast Cancer Statistics are for 1996-2000, are adjusted for the 2000 U.S. standard million population, and represent the number of deaths or new cases of invasive cancer, respectively per year per 100,000 females. 97.2 12.5 Asian/Pacific Islander 58.0 14.9 Amer Indian/Alaska Nat 89.8 17.9 Hispanic/Latina 140.8 27.2 White 121.7 35.9 African-American Breast --Female Incidence Breast--Female Death Group

11. Hispanic/Latino Males: Incidence and Death Rates for Lung Cancer Statistics are for 1996-2000, are adjusted for the 2000 U.S. standard million population, and represent the number of deaths or new cases of invasive cancer, respectively per year per 100,000 females. 52.9 45.6 Amer Indian/Alaska Nat 40.7 46.1 Hispanic/Latina 40.9 62.1 Asian/Pacific Islander 78.1 79.4 White 107.0 120.4 African-American Lung and Bronchus--Male Death Lung and Bronchus--Male Incidence Group

12. Hispanic/Latina Females: Incidence and Death Rates for Lung Cancer Statistics are for 1996-2000, are adjusted for the 2000 U.S. standard million population, and represent the number of deaths or new cases of invasive cancer, respectively per year per 100,000 females. 26.2 23.4 Amer Indian/Alaska Nat 15.1 24.4 Hispanic/Latina 19.1 28.4 Asian/Pacific Islander 41.5 51.9 White 40.0 54.8 African-American Lung and Bronchus--Female Death Lung and Bronchus--Female Incidence Group

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16. Hispanic/Latino Males: Incidence and Death Rates for Prostate Cancer Statistics are for 1996-2000, are adjusted for the 2000 U.S. standard million population, and represent the number of new cases of invasive cancer per year per 100,000 males. Hispanic/Latino males have the third highest incidence and death rates for prostate cancer after African-Americans and whites. 53.6 100.0 137.2 164.3 272.1 Prostate--Incidence 21.9 13.1 24.1 30.2 73.0 Prostate--Death Amer Indian/ Alaska Native Asian/Pacific Islander Hispanic/Latino White African-American Group

18. Hispanic/Latino Males: Incidence & Death Rates for Colorectal Cancer Statistics are for 1996-2000, are adjusted for the 2000 U.S. standard million population, and represent the number of new cases of invasive cancer per year per 100,000 males. 37.5 49.8 57.2 64.1 72.4 Colon and Rectum--Male Incidence 18.5 18.4 15.8 25.3 34.6 Colon and Rectum--Male Death Amer Indian/ Alaska Native Hispanic/Latino Asian/Pacific Islander White African-American Group

19. Hispanic/Latina Females: Incidence & Death Rates for Colorectal Cancer Statistics are for 1996-2000, are adjusted for the 2000 U.S. standard million population, and represent the number of new cases of invasive cancer per year per 100,000 males. 32.6 32.9 38.8 46.2 56.2 Colon and Rectum--Female Incidence 12.1 11.4 11.0 17.5 24.6 Colon and Rectum--Female Death Amer Indian/ Alaska Native Hispanic/Latino Asian/Pacific Islander White African-American Group

20. While Hispanics/Latinos have lower incidence and death rates overall compared with those of African-Americans and whites, they do experience higher rates for certain cancers.

24. Hispanic/Latino Both Sexes: Incidence Rates for Liver and Stomach Cancer Statistics are for 1996-2000, are adjusted for the 2000 U.S. standard million population, and represent the number of deaths or new cases of invasive cancer, respectively per year per 100,000 females. 7.7 4.8 White 11.0 5.9 Amer Indian/Alaska Nat 14.0 6.9 African-American 13.3 9.1 Hispanic/Latino 17.3 13.8 Asian/Pacific Islander Stomach--Incidence Liver--Incidence Group

26. Hispanic/Latina Females: Highest Incidence Rates for Cervical Cancer Statistics are for 1996-2000, are adjusted for the 2000 U.S. standard million population, and represent the number of new cases of invasive cancer per year per 100,000 females. 6.4 Amer Indian/ Alaska Native 9.2 White 10.2 Asian/Pacific Islander 12.4 African-American 16.8 Hispanic/Latino Cervix Uteri--Incidence Group

27. Hispanic/Latina Females: Cervical Cancer Death Rates Statistics are for 1996-2000, are adjusted for the 2000 U.S. standard million population, and represent the number of deaths per year per 100,000 females. Despite high incidence rates, Hispanic/Latina females have the second highest death rate for cervical cancer; African-American females have the highest. 5.9 African-American 2.7 White 2.9 Asian/ Pacific Islander 2.9 Amer Indian/ Alaska Native 3.7 Hispanic/Latino Cervix Uteri--Death Group

29. Gallbladder Cancer: Incidence Rates and Ratios*, 1995-1999 *Ratios calculated as Hispanic incidence divided by non-Hispanic incidence Age-adjusted to the year 2000 population standards. 2.6 1.3 3.4 1.5 0.8 1.2 Gallbladder Ratio Non-Hisp Hispanic Ratio Non-Hisp Hispanic Female Male

30. Gallbladder Cancer: Mortality Rates and Ratios*, 1995-1999 *Ratios calculated as Hispanic mortality divided by non-Hispanic mortality Age-adjusted to the year 2000 population standards. 1.9 0.9 1.7 1.4 0.5 0.7 Gallbladder Ratio Non-Hisp Hispanic Ratio Non-Hisp Hispanic Female Male

31. Cancer Risk Factors Variations in cancer risk factors or screening behaviors between Hispanics and other population groups may be due to cultural differences or socioeconomic factors

37. Cancer Screening Examinations, Adults, 2000-2001 49.5 57.4 41.4 Digital rectal exam 57.6 58.2 46.0 Prostate-specific antigen test Prostate Cancer, 2000 35.3 39.2 31.2 Flexible Sigmoidoscopy or colonoscopy 21.6 24.1 15.4 Fecal Occult Blood Test Colon & Rectum Cancer, 2000 88.8 87.2 83.4 Pap Test Cervical Cancer, 2000 54.8 56.0 53.5 Mammogram & CBE 69.9 68.8 65.1 Clinical breast exam 66.7 62.9 65.4 Mammogram Breast Cancer,2000 %Black, non-Hisp % White, non-Hisp % Hispanic

39. Tobacco Use and Cancer “ The need for a culturally appropriate smoking-cessation intervention for Latinos is based on data on current patterns of tobacco use, possible targeting by the tobacco industry, and the lack of smoking-cessation interventions that are appropriate to the cultural characteristics of Latino smokers” Programma Latino Para Dejar de Fumar initiative in San Francisco

44. Education, Training, and Outreach For non-Latino providers, being able to speak Spanish and having an understanding of Latino culture and subcultures are important skills in screening, diagnosing, and treating Hispanic/Latino patients, although effective interpreter programs may fill in the gap.

51. En Accion uses 5 approaches: Research Demonstration Dissemination Evaluation Policy