A Disparity beneath a Paradox: Cancer Mortality among Young Hispanic Americans in the US-Mexico Border Region.

Abstract

The age-adjusted mortality rate for cancer in the US Hispanic population is two thirds that of the non-Hispanic white population, probably because of differences in smoking rates. We aimed to determine whether Hispanic white (HW) cancer mortality in the US-Mexico Border Region was also lower than that of the non-Hispanic white (NHW) border population, particularly in the younger population less likely to develop smoking-related cancer. We obtained age-adjusted cancer mortality rates from 1999 to 2017 for the 44 border counties, the four US-Mexico border states, and the rest of the US. We obtained cancer incidence rates for 1999-2016 from state registries. We stratified rates by age group, ethnicity, border state, urbanization, and cancer site. Age-adjusted border cancer mortality rates were 139.1/100,000 in the HW and 171.4 in the NHW populations, a ratio of 0.8. HW mortality rates were higher than NHW rates only for the 0-34 age group. State-specific HW cancer incidence rates for people 0-34years old were 77%-80% of NHW rates. We also calculated mortality-incidence ratios (MIR) for the 0-34 population. Border mortality-incidence ratios were higher in the HW population. HW rates exceeded NHW rates for all cancer sites except skin cancer. The HW cancer disparity is due to poorer survival in the HW population, which might be due to limited access to prevention and treatment in a medically underserved area. Mortality among young border Hispanic residents might be reduced through efforts to improve insurance coverage and increase access to medical providers .