Cancer and Hispanics

Cancer is a group of diseases characterized by uncontrolled growth and spread of abnormal cells. The cancer cells form tumors that destroy normal tissue. If cancer cells break away from a tumor, they can travel through the blood stream or the lymph system to other areas of the body, where they might form new tumors (also known as Metastases). If this growth is not controlled, cancer might be fatal.

Not all irregular growths of abnormal cells lead to cancer. A tumor can be either benign (non-cancerous) or malignant (cancerous). Benign tumors do not metastasize and, with very rare exceptions, are not life threatening. Benign tumors usually grow slowly, remain localized, and do not destroy surrounding normal tissue.

All cancers develop because of damage or mutation of the genes that control cell growth and division. These genetic changes can be caused by exposure to external factors (for example, tobacco, poor diet, alcohol, chemicals, sunlight, radiation, and infectious organisms) or internal factors (for example, inherited mutations, hormones, immune conditions, and mutations that occur from metabolism). Approximately five to 10 percent of cancers are caused by various inherited gene mutations that predispose people to developing certain cancers.

External and internal factors often act together in sequence to initiate or promote cancer development. Many years often pass between exposures or mutations and detectable cancer. Because of this, it is often difficult to directly identify causes of specific cancer cases.

Hispanics are the largest, fastest-growing, and youngest minority group in the United States (U.S.), and the second largest minority group in Indiana. In 2012, approximately 6 percent of the population (389,094 people) identified themselves as Hispanic or Latino. This is up from 3.5 percent in 2000. Nationally, cancer is the leading cause of death among Hispanics, accounting for 21 percent of deaths overall and 15 percent of deaths in children.

It is important to note that most cancer data in Indiana and the U.S. are reported for Hispanics as an aggregate group, which masks important differences that exist between Hispanic sub-populations according to country of origin. Also, because the U.S. Hispanic population is very dynamic as a result of the influx of new immigrants, trends reflect the cancer risk of incoming Hispanics, as well as changes in the risk of established residents.

What Types of Cancer Impact the Hispanic Community the Most?

In Indiana, during 2006-2010, lung and bronchus cancer was the most common cause of cancer-related death among Hispanic men (18.5 percent) and breast cancer was the most common cause of cancer-related death among Hispanic women (13.1 percent). In contrast, the leading cause of cancer death in non-Hispanic women is lung cancer. The second leading cause of cancer death among Hispanic men was prostate cancer (10.6 percent), and lung and bronchus cancer was the second leading cause of cancer death among women (12.3 percent). Colorectal cancer was the third leading cause of cancer deaths among both sexes (8.8 percent for men and 10.3 percent for women).

During 2006-2010, the cancer incidence rate among Hoosier Hispanics was 305.3 cases per 100,000 people, and the cancer mortality rate (or death rate) was 98.5 deaths per 100,000 Hispanic people. Cancer incidence and mortality rates among Hispanics in Indiana and the United States have gradually decreased over time. From 2001 to 2010 the incidence rate decreased 25 percent in Indiana and 10 percent nationally. During this same time period, the mortality rate decreased by 11 percent in both Indiana and the United States.

Prevention

Many cancers can be prevented by modifying external risk factors and making lifestyle changes, such as eliminating tobacco use, improving dietary habits, increasing physical activity, losing weight and avoiding excessive sun and infectious disease exposure. For example:

  • Avoid tobacco use and secondhand smoke.
    • During 2012, 18.9 percent of Hispanic adults reported being current smokers.
  • Limit alcohol consumption.
  • Maintain a healthy weight.
    • During 2012, in Indiana, just over 30.3 percent of Hispanic adults were considered obese.
    • Consume a healthy diet that emphasizes plant sources, includes five or more servings of a variety of vegetables and fruit each day, includes whole grains in preference to processed or refined grains, and has minimal processed and red meats.
      • Only 27 percent of Hispanic adults reported consuming two or more fruits per day, and only 16.2 percent reported eating three or more vegetables per day during 2012.
    • Adopt a physically active lifestyle.
      • During 2012, about 60 percent of Hispanic adults did not get the recommended 150 minutes of exercise per week.
  • Protect yourself from too much sun exposure.
  • Talk to your primary health provider about:
    • Any potential signs and symptoms of cancer, including unexplained weight loss, fever, fatigue, pain and skin changes.
    • Cancer screening options for breast, cervical, colorectal and prostate cancers.
    • Vaccines that can reduce your risk for developing cancer, like hepatitis B and human papillomavirus (HPV).

Early Detection

Early detection tests can lead to prevention of cancer through the identification and removal of precancerous lesions, particularly for cancer of the cervix and colon and rectum.

  • Screening can detect cancer at an earlier stage, when treatment is most effective.
  • During 2012, nationally among Hispanics:
    • 6 percent of women ages 40 and older had a mammogram within the past two years
    • 6 percent of women ages 18 and older had a Pap test within the past three years
    • 4 percent of people ages 50 and older had ever had a colonoscopy or sigmoidoscopy

How is Cancer Staged?

A cancer’s stage is based on the primary tumor’s size and location in the body, and whether it has spread to other areas of the body. There are two main staging systems used to classify tumors.

  • TNM staging system — This system assesses tumors in three ways: extent of the primary tumor (T), absence or presence of regional lymph node involvement (N), and absence or presence of distant metastases (M). Once the T, N and M are determined, a stage of I, II, III or IV is assigned, with stage I being early stage and IV being advanced.
  • Summary staging — This is useful for descriptive and statistical analyses of cancer data. An in situ tumor is at the earliest stage when it has not invaded surrounding tissue; it can only be diagnosed by microscopic examination. A localized tumor has not spread beyond the primary organ. A regional or distant tumor has spread to other parts of the body, either through the blood or lymph systems. With an unstaged/unknown tumor, there is insufficient information available to determine the stage of the disease.

Staging is essential in determining treatment and assessing prognosis. It is a strong predictor of survival; generally, the earlier the stage, the better the prognosis. Locally and nationally, about half of newly diagnosed cases are either in situ or localized.

How is Cancer treated?

Treatment depends on the cancer type and stage, specific diagnosis, and overall health of the individual. Cancer is treated by one or more of the following therapies:

  • Surgery removes the tumor by cutting out the cancerous mass; it is mostly used for localized tumors.
  • Chemotherapy uses either intravenous or oral drugs to destroy cancer cells. It is used with the intention of curing or inducing remission in cancers in early stages.
  • Hormone therapy might be given to block the body’s natural hormone and to slow or stop the growth of certain cancers.
  • Immunotherapy (or biologic therapy) is used to stimulate and strengthen a person’s own immune system to destroy the cancer cells.
  • Radiation or radiotherapy uses high-energy rays to destroy or slow the growth of cancer cells. It can be done with the intention of curing some cancers that have not spread too far from their site of origin or to relieve symptoms.

Can Cancer be cured?

Many cancers can be cured if detected and promptly treated. For most types of cancer, if a person’s cancer has been in remission (which means that all signs and symptoms of the disease are absent) for five years, the cancer is considered cured. However, the length of remission at which a person is considered cured differs by cancer type. Certain skin cancers, such as a basal cell carcinoma, are considered cured as soon as the lesion is removed. For other cancers (for example, pancreatic cancer), eight to 10 years must pass before the person is considered cured.

Resources

  • Cancer Among Hispanics Fact Sheet — Use this fact sheet to educate your partners and communities. The fact sheet provides information and statistics on the cancer burden for African-Americans in Indiana.
  • 2012 Indiana Facts and Figures — Provides current statistics and information on cancer in Indiana in convenient PDF form. This can be linked to documents, websites, presentations, or through social media.
  • Indiana Cancer Control Plan 2010-2014 — Provides a roadmap for cancer control in Indiana. The ICCP includes six focus areas: primary prevention, early detection, treatment, quality of life, data, and advocacy. This can be linked to documents, websites, presentations, or through social media.

Additional and online resources: