U.S. demographic snapshot, cancer incidence, and mortality in the Latino population
Studies and Publications undertaken by Nueva Vida in Partnership with Researchers
Since 2000, Nueva Vida has collaborated with academic researchers on the implementation and publication of critical studies that have helped to fill the gap on much needed research related to cancer disparities among Latinos. Nueva
Vida’s core research component provides a strong systematic research and evaluation element that has significantly made a difference in the ways we measure and evaluate program effectiveness. To learn more about our research
or discuss ways in which we can collaborate, please email:
[email protected].
US Demographic Snapshot & Cancer Incidence & Mortality In the Latino Population
The 2010 US Census found that Latinos are the fastest growing ethnic group in the nation and accounted for most of the national population growth. The US Census Bureau projects that the size of the Latino population is expected to increase from 15 percent to 30 percent by the year 2050; if this figure proves correct, one in every three United States residents will be Latino by 2050.
Nevertheless, the Latino population is a medically underserved community with barriers to access to care and high incidence of cancer mortality. For instance, Breast cancer is the leading incident cancer and leading cause of cancer death in Latino women. Although incidence rates are lower in Latino women than in Non-Hispanic White (NHW) women, the rate of decline in incidence rates since 2000 is lower for Latinos than for NHWs. Latino women are more likely to be diagnosed at later stages and with larger tumors and they are 20% more likely to die from their breast cancer than NHW women.
Overall, about 1 in 3 Hispanic men and 1 in 3 Hispanic women will be diagnosed with cancer in their lifetime. The lifetime probability of dying from cancer is 1 in 5 for Hispanic men and 1 in 6 for Hispanic women. Cancer is the leading cause of death among Hispanics, accounting for 22% of deaths in 2012.
National Leading Sites of Cancer Cases and Mortality Rates - 2015 for all Latinos
| Site | Estimated Cases | Estimated Deaths | ||
|---|---|---|---|---|
| Male | Female | Male | Female | |
| Colorectal | 11% | 8% | 11% | 9% |
| Breast | 29% | 16% | ||
| Cervical | 3% | 4% | ||
| Lung and Bronchus | 9% | 7% | 17% | 13% |
Incidence Rates by State, National & Race & Ethnicity-2017
| Site/Race and Ethnicity | Virginia | Maryland | D.C. | Total U.S. |
|---|---|---|---|---|
| Latinos | ||||
| Breast | 80.7 | 91.8 | 70.8 | 92.3 |
| Cervical | 10.7 | 8.7 | ** | 9.7 |
| Colorectal | 26.5 | 25.2 | 28.4 | 35.0 |
| African Americans | ||||
| Breast | 132.7 | 131.3 | 140.0 | 122.8 |
| Cervical | 7.8 | 7.5 | 11.6 | 9.2 |
| Colorectal | 43.8 | 42.3 | 52.7 | 46.7 |
| NHWs | ||||
| Breast | 130.0 | 135.2 | 157.6 | 128.6 |
| Cervical | 5.6 | 5.7 | 4.5 | 7.0 |
| Colorectal | 35.8 | 36.5 | 26.2 | 39.4 |
Source: American Cancer Society. Cancer Facts & Figures for Hispanics/Latinos 2015-2017. Atlanta: American Cancer Society; 2015.
Non-Hispanic White’s and African American women have the highest breast cancer incidence overall
African American women have the highest breast cancer mortality overall
Source: Howlader N, Noone AM, Krapcho M, et al., editors. SEER Cancer Statistics Review, 1975-2014. Table 4.18. Bethesda, MD: National Cancer Institute. https://seer.cancer.gov/csr/1975_2014/, 2017.
In a nationally representative sample of Hispanics, those from Mexico, Central America, and South America were less likely to receive cancer screenings relative to other Hispanic subgroups.
Mammography Screening (Had a Mammogram in Past 2 years 40+) by Percentage
| R/E | D.C. | Virginia | Maryland | Total U.S. |
|---|---|---|---|---|
| Latino | 64.9% | 63.1% | 82.2% | 72.2% |
| African American | 79.0% | 84.3% | 84.6% | 78.3% |
| NHW | 71.6% | 73.9% | 77.8% | 73.3% |
Created by statecancerprofiles.cancer.gov on 12/21/2017 10:53 am
Facts on Breast Cancer Among
Latina/Hispanic Women
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The Hispanic population is the fastest growing major demographic in the United States, and Latina women are more likely to have lower participation rates in cancer screening and other prevention programs
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In a nationally representative sample of Hispanics, those from Mexico, Central America, and South America were less likely to receive cancer screenings relative to other Hispanic subgroups
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Latinas have higher breast cancer mortality than non-Latina white women due to lower screening rates and limitations in access to timely care due to socioeconomic factors
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After diagnosis of cancer amongst Latina patients, systemic therapy is the single treatment modality with the greatest potential to reduce survival disparities
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Latinas have been noted to have fewer consultations with medical oncologists, receive less aggressive chemotherapy regimens, be more likely to discontinue chemotherapy than whites, and be less likely to have endocrine therapy prescribed than white women
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Latina immigrants who lack English skills are less likely to receive the care and medical information that they need, especially after entering the health care system and experiencing barriers that lead to miscommunication which limit their ability to make treatment decisions
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Often times Latinas have low knowledge and self-efficacy in the context of cancer, and it leads them to have misconceptions or negative expectations regarding chemotherapy
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The reduction of systemic barriers such as access to health care and transportation can facilitate early detection of breast cancer among Latinas
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Embarrassment is often times a strong barrier for participants because they do not want to show their breasts in medical or intimate contexts
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Most Latina women do not perceive doctors as trustworthy gatekeepers of health information
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Latina women need to have confianza, simpatia, respeto, and personalismo with their health care providers in order to establish trust
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Health disparities pertaining to breast cancer arise from the institutional, psychosocial, and cultural contexts in which Latinas are diagnosed
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Latinas experience a 5-year survivorship rate of 76% due to being detected at a later stage, having treatment delays, and lower quality of care
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A number of negative posttreatment effects, including fatigue, depression, and strained work and spousal relationships appear greater among Latina survivors compared to white women
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Among Latina women, the word “cancer” is equated with death in their home countries
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Some Latina women reported feelings of shame and secrecy related to their breast cancer and/or sexual functioning-feelings that at times extended to partners of patients, perhaps in part due to Latino machismo
References:
Buki, L. P., Garcés, D. M., Hinestrosa, M., Kogan, L., Carrillo, I. Y., & French, B. (2008). Latina breast cancer survivors’ lived experiences: diagnosis, treatment, and beyond. Cultural diversity and ethnic minority psychology, 14(2), 163.
Haile, R. W., John, E. M., Levine, A. J., Cortessis, V. K., Unger, J. B., Gonzales, M., … & Bernstein, J. L. (2012). A review of cancer in US Hispanic populations. Cancer Prevention Research, 5(2), 150-163.
Lopez-Class, Maria, et al. “Quality of life among immigrant Latina breast cancer survivors: realities of culture and enhancing cancer care.” Journal of Cancer Education 26.4 (2011): 724-733.
Sheppard, Vanessa B., et al. “Latina a LatinaSM: developing a breast cancer decision support intervention.” Psycho‐Oncology17.4 (2008): 383-391.
Collaborations
Utilizing Community-Based Participatory Research (CBPR) allows researchers and engaged community participants to really investigate key issues that will encourage behavioral changes that could eventually expand the knowledge base about Latinas
with breast cancer and what interventions are the most effective. The more researchers work in the community environment, the more precise their research will be to find the realities and the needs of the population.
Avon Breast Cancer Crusade/Pfizer Oncology (2016-2017)
Research dedicated to our program Nueva Vida, Nueva Esperanza (New Life, New Hope) the first program of its kind to support a medically underserved heterogeneous Latina immigrant group with metastatic breast cancer (MBC). The overall goal
of Nueva Vida, Nueva Esperanza is to provide a more detailed understanding of the specific psychosocial, logistic and health care system barriers to treatment and improve quality of life for Latinas with MBC and their caregivers through
a program designed with and for this medically underserved population.
Georgetown University
PI: Kristi D. Graves, PhD (2013-2017)
Less is known about ways to improve Latinas’ QOL. Family members/friends who serve as caregivers to Latina survivors are also impacted by the diagnosis. Many caregivers feel they do not have the coping skills to support the survivor
or care for themselves. They also experience family stress. A randomized controlled trial with 200 people (100 survivor-caregiver pairs) to improve QOL for survivors and caregivers was conducted. The intervention was developed
by Latina survivors and has been used successfully at Nueva Vida for more than two years. Survivor caregiver pairs were assigned by chance to the intervention or usual care. Latina breast cancer survivors and caregivers assigned
to the intervention will attended eight group sessions, held twice a month. Each session covered a different topic such as communication, stress management, treatment side effects, or impact of cancer on family.
American University
PI: Maria de Jesus, PhD (2014-2016)
Using a Community-Based Participatory Research (CBPR) approach, American University (AU) and Nueva Vida (NV), designed an educational intervention study that develops, implements and evaluates a mobile health (m-Health) strategy using mobile phone communication technology to deliver personalized, culturally and linguistically tailored educational messages that will resonate with Hispanic women. This educational intervention compared text messages versus voice messages to determine which strategy is more likely to enhance knowledge of breast cancer and mammography and increase adherence to mammography screening. Data is currently being analyzed for dissemination and publication.
Studies and Publications
A particular strength of Nueva Vida has been the engagement in research partnerships with cancer centers and academic institutions that have resulted in, among others, publications in peer-reviewed scientific journals.
Objective and Methodology:
Latina breast cancer survivors not benefiting from advances in psychosocial interventions.Limited information about this population. This qualitative study examined the experiences of 18
immigrant Latina breast cancer survivors along the survivorship continuum, from diagnosis to long-term survivorship.
(qualitative – focus groups)
Partners:
Lydia Buki, Ph.D. Associate Professor, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign
Objective and Methodology:
Aims were to: (1) identify factors in Latinas’ treatment decision making and (2) develop and pilot a decision support intervention
(formative – pilotintervention)
Partners:
Sheppard, V. B, Figueiredo, M., Cañar, J., Goodman, M., Caicedo L., Kaufman, A., Norling, G., Mandelblatt, J., Latin American Cancer Research Coalition, Georgetown-Lombardi Comprehensive Cancer Center
Objective and Methodology:
This study examined social, cultural, and health care system factors that impact quality of life and survivorship experiences of Latina immigrant breast cancer survivors.
(qualitative study – interviews, focus groups)
Partners:
M. Lopez-Class, M. Perret-Gentil, B Kresling, L Caicedo, J.s.Mandelblatt, K.D. Graves.Latin American Cancer Research Coalition, Georgetown-Lombardi Comprehensive Cancer Center
Objective and Methodology:
(1) Determine if navigation will be more effective than no navigation in decreasing the time from suspicious finding to diagnostic resolution and the time from diagnosis to treatment initiation.
(2) Determine if navigation is the most cost-effective strategy in terms of costs per quality adjusted year of life saved. (3) Determine what factors mediate the intervention effects.
Partners:
Patierno et al,George Washington University and the National Cancer Institute
Objective and Methodology:
There is a paucity of data on determinants of clinical trial participation in the growing and diverse US Latino population. We describe correlates of awareness of and willingness to participate
in clinical trials among Central and South American Latinos using safety net clinics.
(cross-sectional survey)
Partners:
S.F. Wallington, G. Luta, A.M. Noone, L.Caicedo, M. Lopez-Glass, V. Sheppard, C. Spencer, J. Mandelblatt
Objective and Methodology:
To undertake an evaluation of NV’s access and mental health programs to determine to what extent the NV model results in improved self-efficacy at the individual level;
To examine the effect of NV’s programs on levels of self-efficacy, psychological distress, and quality of life as primary outcomes.
(quasi experimental time-series design)
Partners:
KarlynnBrintzenhofeSzoc, PhD, MSW, OSW-C, James R. Zabora, ScD National Catholic School of Social Service of The Catholic University of America
Objective and Methodology:
To describe how a community/university partnership can be successful though both groups working towards the common goal of improving patient services.
Partners:
Karlynn Brintzenhofe Szoc, PhD, MSW, OSW-C, James R. Zabora, ScD.National Catholic School of Social Service of The Catholic University of America
Additional Publications
Darling M, Gonzalez F, Graves K, et al., Practical Tips for Establishing Partnerships With Academic Researchers: A Resource Guide for Community-Based Organizations, Progress in Community Health Partnerships (Summer 2015).
Patient Navigation Significantly Reduces Delays in Breast Cancer Diagnosis in the District of Columbia Cancer Epidemiol Biomarkers Prev. 2012 Oct;21(10):1655-63.
Elashoff, D., Zhou, H., Reiss, J., Wang, J., Xiao, H., Henson, B., … & Messadi, D. (2012). Prevalidation of salivary biomarkers for oral cancer detection. Cancer Epidemiology and Prevention Biomarkers, 21(4), 664-672.
Hoffman, H. J., LaVerda, N. L., Young, H. A., Levine, P. H., Alexander, L. M., Brem, R., … & Huerta, E. (2012). Patient navigation significantly reduces delays in breast cancer diagnosis in the District of Columbia.
Juliana Munoz, Christina Rush, Bess Flashner, Ghipsel Cibrian, Sandra Martinez, Claudia Campos, et al., “The song inside”: “La canción por dentro”—Individual and dyadic impact of breast cancer for caregivers of Latina survivors. Psychooncology. 2016 Nov 27. doi: 10.1002/pon.4326
Lopez-Class, M., Perret-Gentil, M., Kreling, B., Caicedo, L., Mandelblatt, J., & Graves, K. D. (2011). Quality of life among immigrant Latina breast cancer survivors: realities of culture and enhancing cancer care. Journal of Cancer Education, 26(4), 724-733.
Rush,C.L., M. Darling, M.G. Elliott et al., Engaging Latina Cancer Survivors, their Caregivers, and Community Partners in a Randomized Controlled Trial: Nueva Vida Intervention Quality of Life Research 24(5) (May 2015): 1107-1118.
Rush, C.L.; Lobo, T.; Serrano, A.; Blasini, M.; Campos, C.; Graves, K.D . Complementary and Alternative Medicine Use and Latina Breast Cancer Survivors’ Symptoms and Functioning. Healthcare 2016, 4, 80.
