Hispanics, the fastest-growing population group in the United States, are less likely to be diagnosed in the early stages of certain cancers, reducing their medical access to life-saving care, a government report says.
The report, released yesterday by organizations that include the National Cancer Institute, annually updates trends in the incidence rate of a variety of cancers since 1975. It also found the incidence of breast cancer overall in the nation stabilized from 2001 to 2003 for the first time in two decades, while thyroid cancer in women increased.
Americans' risk of dying from any form of cancer has continued to drop since the 1990s, the report said.
Rates for some top cancers among Hispanics may rise without education and prevention efforts, the groups said.
Hispanics “are going for treatment late and being diagnosed with late-stage disease,” said Elmer Huerta, director of Washington Hospital Center's Cancer Preventorium. “Then you have a recipe for disaster.”
Huerta is developing ads to increase use of cancer screening and other health resources.
Hispanics may be less likely to get screening because many lack health insurance, and they are unlikely to seek health care unless they have symptoms, aches or pains.
Being diagnosed in the later stages is associated with a higher risk of death in almost all cancers, said Brenda Edwards, associate director of NCI's Surveillance Research Program, at a news conference at the National Institutes of Health in Bethesda, Md.
Hispanics had lower rates of common killers such as cancers of the lung, prostate and breast than whites, according to the study. The report is the most detailed look yet at the disease among Hispanics, who make up 14 percent of the U.S. population, or 43 million people.
The report, which includes information on cancer from 90 percent of the U.S. Hispanic population, “points to the urgent need to educate people about the ways to reduce their cancer risk and keep rates such as these as low as possible,” said John Niederhuber, director of the National Cancer Institute at NIH.
While Hispanics are less likely to be diagnosed with the major forms of cancer, they are more susceptible to some less common forms, the study said.
Hispanic children are at increased risk of developing blood, eye and bone cancers compared with whites. Adult Hispanics are at increased risk of developing cancers spread by viruses, such as cervical cancer, viral-associated forms of stomach cancer, and liver cancers linked to hepatitis viruses.
Hispanic women do get breast cancer at the same rates as other racial groups, and breast cancer is one disease for which early treatment can send the condition into permanent retreat.
“We can reverse this course of breast cancer with early detection,” said Dr. William Stanton, an oncologist with Scripps Mercy Hospital in Hillcrest. Stanton said that with Hispanics and members of other cultures, there is sometimes an awkwardness about breast self-exam or allowing a doctor to look for lumps.
One successful outreach method is using Spanish-speaking peer educators to get Hispanic women to overcome their fears about breast-cancer prevention, he said.
Numerous reasons discourage Hispanics from getting screened for many types of preventable cancer, said Georgia Sadler, associate director of the University of California San Diego's Rebecca and John Moores Cancer Center in La Jolla.
“They say, 'None of my friends are doing this, why should I?' or, 'I didn't know this was important,' or, 'No one told me I should do this, so how could I have known?' ” Sadler said.
Finances can also be a challenge, she said, because many Hispanic women don't qualify for health coverage or may not be residing legally in the United States.
“In a community of well-educated people with the capacity to purchase services, the word gets around. But if you live in a community with limited resources, you don't know what's out there . . . and you don't go looking for it,” Sadler said.
Julie Gerberding, director of the national Centers for Disease Control and Prevention, which helped compile the report, said health providers “must continue to fight to ensure that resources are available to address the importance of prevention, screening, and early detection, and promoting healthy behaviors which are proven strategies to reduce the burden of cancer.”
While the finding that breast cancer rates have stabilized may be provocative, the cause remains unclear, the report said. Data for the next few years will determine whether the finding is a trend or a random fluctuation.
While most major cancer rates declined overall, thyroid cancer cases in women rose 2.2 percent annually from 1981 to 1993, 4.6 percent per year from 1993 to 2000 and 9.1 percent per year from 2000 to 2003, the study said. The increase in men was not as great as among women, it said.
National Cancer Institute scientists are looking into what the trend for thyroid cancer stems from, NCI's Edwards said. Doctors may be detecting more cancers when screening for other cancers, or the higher incidence may be related to factors such as exposure to X-rays and other medical radiation, she said.
The report, first issued in 1998, is a joint project of the NIH, CDC, the American Cancer Society and the North American Association of Central Cancer Registries.
Staff writer Cheryl Clark contributed to this report.
