Study Suggests Risk of Cancer Death Increases with Each Generation of Latinos Born in the United States

According to the U.S. Census Bureau, as of July 2016, the Hispanic population in the United States had grown to 57.5 million, making people of Hispanic origin the nation's largest ethnic or racial minority group. Studies have shown that U.S.-born Latinos have a higher incidence of cancer than foreign-born Latinos. To better understand the influence that acculturation and environmental factors have on cancer risks in Latinos in the United States, Setiawan et al launched a large observational study examining the cancer mortality patterns across first-generation immigrants and second- and third-generation U.S.-born Mexican Americans. 

The study's findings show that the highest cancer death rate occurred among third-generation U.S.-born Latinos, followed by second-generation Latinos with one or both parents born in Mexico. The lowest cancer death rate occurred among first-generation immigrants. The study also found the risk of dying from certain cancers, including lung, colorectal, and liver cancers, was significantly higher among third-generation U.S.-born Latinos compared with first-generation Mexico-born immigrants.

Key Points Latinos in the United States experience an increased risk of cancer death with each generation born in the United States. The highest cancer death rate occurred among third-generation U.S.-born Latinos, followed by second-generation Latinos with one or both parents born in Mexico. The lowest cancer death rate occurred among first-generation immigrants. The risk of dying from certain cancers, including lung, colorectal and liver cancers, was significantly higher among third- generation U.S.-born Latinos compared with the first- generation Mexico-born immigrants.

The study was presented at the 11th AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved (Abstract C084).

The researchers analyzed data from 29,308 Latinos of Mexican origin participating in the Multiethnic Cohort Study of Diet and Cancer funded by the National Cancer Institute. The participants were between the ages of 45 and 74 years, and they entered the study between 1993 and 1996. Cox models were used to estimate the relative risk (RR) and 95% confidence intervals (CI) for cancer mortality associated with generation, adjusted for risk factors for cancer mortality, at cohort baseline.

Study Results

During an average of 17.7 years, 2,915 cancer deaths were identified. The researchers found that the highest death rate (per 100,000) occurred among third-generation U.S.-born Latinos (age-adjusted rate = 537); followed by second-generation Latinos with one parent born in the United States (526 per 100,000) or both parents born in Mexico (481 per 100,000). The lowest cancer death rate occurred among first-generation immigrants (381 per 100,000).

After adjusting for education, lifestyle factors, and preexisting illnesses, Latino generation was associated with cancer mortality risk (P trend < .0001). The risk for third-generation U.S.-born, second-generation with one parent U.S.-born, and second-generation with both parents Mexico-born was significantly higher compared to first-generation immigrants (RR = 1.37 [95% CI = 1.21–1.54], 1.27 [1.12-1.44], and 1.20 [1.08-1.33], respectively). Restricting analyses to the Minimum Essential Coverage (MEC)-Medicare enrollees, for whom data indicated they are living in the United States and are eligible for national health insurance coverage, yielded similar results.

In specific cancer site analyses, the researchers found associations between generation with lung cancer (P trend = .014), colorectal cancer (P trend = .004), liver cancer (P trend = .006), and possibly breast cancer (P trend = .053). The risks of lung cancer (RR = 1.46 [1.09-1.97]), colorectal cancer (RR = 1.95 [1.28–2.95]), and liver cancer (RR = 1.87 [1.22–2.85]) deaths were significantly higher among third-generation U.S.-born compared to first-generation Mexico-born immigrants.

The risks of prostate, stomach, and pancreatic cancers were similar across generations.

Changing Risk Factors

“The disparities in cancer mortality we observed in U.S. Latinos are likely due to changes in lifestyle, health behaviors, and social factors,” said Veronica Wendy Setiawan, PhD, Associate Professor of Preventive Medicine, Keck School of Medicine at the University of Southern California in Los Angeles, and lead author of this study, in a statement. “This study is a reminder that some factors that contribute to cancer risk are modifiable.”

Dr. Setiawan declared no conflicts of interest. Funding for the study was provided by the National Cancer Institute.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.

Source: Published originally on ascopost.com, Study Suggests Risk of Cancer Death Increases with Each Generation of Latinos Born in the United States, by Jo Cavallo, November 5^th, 2018.

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