Neighborhood composition and incidence of cancer among Hispanics in the United States

Abstract

Background: Hispanics in the United States have a 33% lower age-adjusted incidence of cancer and a 38% lower cancer mortality rate compared with non-Hispanic whites. This may be secondary to health behaviors that vary with residential and economic assimilation. The authors investigated whether cancer incidence among Hispanics increased with residential and economic assimilation into mainstream culture.

Methods: Data from the Surveillance, Epidemiology, and End Results program (SEER) and the U.S. Census Bureau were used to compare cancer incidence rates and rate ratios as a function of percentage of Hispanics and income of Hispanics in a census tract. Type of cancer was identified with a site recode variable in the SEER data set. Cases with in situ prostate and cervical carcinoma were excluded. Hispanic ethnicity in SEER was identified by medical record review and Hispanic surname lists. The study also used income of Hispanics living in the census tract, age at diagnosis, and stratification by gender.

Results: The incidence of breast, colorectal, and lung carcinoma among Hispanics increased as the percentage of Hispanics in the census tract decreased and as tract Hispanic income increased. For example, there was a 39% reduction in breast carcinoma and a 38% reduction in male colorectal carcinoma when the Hispanic population in high-density Hispanic neighborhoods in the lowest income quartile was contrasted to Hispanics living in tracts with the lowest total percentage of Hispanics in the highest income quartile.

Conclusions: The lower cancer rates among Hispanics relative to non-Hispanic whites in the United States may dissipate as Hispanics become more assimilated into the mainstream society.

FIGURE 1

Distribution of the total Hispanic population among the census tracts in the nine Surveillance, Epidemiology, and End Results registry areas by tract percent Hispanic and Hispanic income quartile.

FIGURE 2

Incidence rates (per 100,000) of 5 common cancers in Hispanics, as a function of the percentage of Hispanics comprising the census tract and Hispanic income quartile. Data are the incidence rates reported in Table 1. Age-adjusted incidence rates (per 100,000) were directly standardized using the U.S. 2000 population standard.