Cancer Site-Specific Disparities in New York, Including the 1945-1965 Birth Cohort's Impact on Liver Cancer Patterns

Abstract

Background: Analyses of cancer patterns by detailed racial/ethnic groups in the Northeastern United States are outdated.Methods: Using 2008-2014 death data from the populous and diverse New York State, mortality rates and regression-derived ratios with corresponding 95% confidence intervals (CIs) were computed to compare Hispanic, non-Hispanic white (NHW), non-Hispanic black (NHB), Asian populations, and specific Hispanic and NHB subgroups: Puerto Rican, Dominican, South American, Central American, U.S.-born black, and Caribbean-born black. Special analyses on liver cancer mortality, given the higher prevalence of hepatitis C infection among the 1945-1965 birth cohort, were performed.Results: A total of 244,238 cancer-related deaths were analyzed. Mortality rates were highest for U.S.-born blacks and lowest for South Americans and Asians. Minority groups had higher mortality from liver and stomach cancer than NHWs; Hispanics and NHBs also had higher mortality from cervical and prostate cancers. Excess liver cancer mortality among Puerto Rican and U.S.-born black men was observed, particularly for the 1945-1965 birth cohort, with mortality rate ratios of 4.27 (95% CI, 3.82-4.78) and 3.81 (95% CI, 3.45-4.20), respectively.Conclusions: U.S.-born blacks and Puerto Ricans, who share a common disadvantaged socioeconomic profile, bear a disproportionate burden for many cancers, including liver cancer among baby boomers. The relatively favorable cancer profile for Caribbean-born blacks contrasts with their U.S.-born black counterparts, implying that race per se is not an inevitable determinant of higher mortality among NHBs.Impact: Disaggregation by detailed Hispanic and black subgroups in U.S. cancer studies enlightens our understanding of the epidemiology of cancer and is fundamental for cancer prevention and control efforts. Cancer Epidemiol Biomarkers Prev; 27(8); 917-27. ©2018 AACR.

Figure 1. Increased mortality for liver cancer among Puerto Rican men and US-born Black men and women in the 1945–1965 birth cohort

Age-specific rates by racial/ethnic group. (Age-specific rates per 100,000 for the age group 65–69 born outside the birth cohort were as follows: Males NHW 26.9, NHB 50.9, Asian 41.5, Hispanic 51.5, USB Black 67.5, PR 76.8; Females NHW 9.4, NHB 10.5, Asian 12.6, Hispanic 21.0, USB Blacks 10.8, PR 33.8) New York State, 2008–2014.