While heart disease still edges out cancer among all Americans, cancer is the number one killer among Hispanics in Texas. Yet their prognosis remains superior to Caucasians, a Hispanic paradox that debunks the notion that income and education are key factors in health care.
Hispanic Americans tend to survive illness and live longer than white Americans with the same diseases even though the Hispanics have less education, income and access to health care.
More Hispanics than ever are in Texas - the population has more than doubled since 1990, to 38 percent of the state's population - so a new analysis of medical records by the Comparative Effectiveness Research on Cancer in Texas research group may be beneficial in understanding how to optimize health care.
Based on data from the Texas Cancer Registry, Medicare claims records and state vital statistics, researchers compared rates and trends for cancer in Hispanics to those for non-Hispanic whites in Texas and find:
- Survival after a diagnosis of cancer is superior for Hispanics compared to non-Hispanic whites.
- Overall mortality from all cancer was lower among Hispanics with the exception of stomach and liver cancer.
- Hispanic Texans are less likely to be screened for breast or colon cancer and have lower rates of new cancer diagnoses for breast, colon and lung cancer.
- Of the cancers diagnosed in Hispanics, fewer were in the earliest, most treatable stages – those typically detected through screening. Breast cancer at the most advanced stage was diagnosed at a 12 percent higher rate.
- Cancers more common among Hispanics were stomach and liver cancer in men and stomach, liver and cervical cancer in women. Such cancers can arise from untreated infections.
These findings were based on 10 years of data about the diagnoses of new cancer cases and 21 years of data about cancer deaths.
The CERCIT researchers noted one puzzling contradiction. Even though cancers tend to be more advanced when diagnosed in Hispanics, death rates were lower than in the white population. This Hispanic Paradox has also been noted by other epidemiologists looking at disease and survival rates across the spectrum. Foreign-born Hispanics had lower mortality rates than those born in the United States, according to analyses of regional differences within the state.
The CERCIT project is led by principal investigator Dr. James S. Goodwin of University of Texas Medical Branch at Galveston and co-principal investigator Dr. Linda S. Elting of the University of Texas MD Anderson Cancer Center. Other project and core lead investigators include Drs. Catherine D. Cooksley, Anthony DiNuzzo, Karl Eschbach, Jean Freeman and Taylor S. Riall of UTMB; Dr. Sharon H. Giordano of MDA; Dr. Vivian Ho of Rice University and Dr. Melanie Williams of the Texas Cancer Registry.