Abstract
BACKGROUND: The Hispanic population is the second largest racial/ethnic group in the United States, consisting of multiple distinct ethnicities. Ethnicity-specific variations in cancer mortality may be attributed to countries of birth, so we aimed to understand differences in cancer mortality among disaggregated Hispanics by nativity (native- or foreign-born vs. US-born) over 15 years. METHODS: A total of 228,197 Hispanic decedents (Mexican, Puerto Rican, Cuban, and Central or South American) with cancer-related deaths from US death certificates (2003-2017) were analyzed. Seven cancers that contribute significantly to Hispanic male (lung and bronchus, colon and rectum, liver, prostate, and pancreas cancers) and female (lung and bronchus, liver, pancreas, colon and rectum, female breast, and ovary cancers) mortality were selected for analysis. 5-year age-adjusted mortality rates [(95% confidence interval); per 100,000] and standardized mortality ratios (95% confidence interval) using foreign-born as the reference group were calculated. Joinpoint regression analysis was used to model cancer-related mortality trends. RESULTS: Puerto Rico-born Puerto Ricans, Cuba-born Cubans, and US-born Mexicans had some of the highest cancer death rates among all the Hispanic groups. In general, foreign-born Hispanics had higher cancer mortality rates than US-born Hispanics, except Mexicans. Overall, US-born and non-US-born (i.e., native- or foreign-born) Hispanic groups experienced decreasing rates of cancer deaths over the years. CONCLUSIONS: We noted vast heterogeneity in mortality rates by nativity across Hispanic groups, a fast-growing diverse US population. IMPACT: Understanding disaggregated patterns and trends in cancer burden can motivate deeper discussion around community health resources, which may improve the health of Hispanics across the United States.