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Latinas: Breast and Cervical Cancer
Among Mexican American and Puerto Rican women, cervical cancer incidence is two to three times higher than in non-Hispanic White women. (2)
Only 38% of Hispanic women age 40 and older have regular screening mammograms, a simple procedure that can detect breast cancer at its earliest stage, before clinical symptoms develop. (4-6)
Hispanics experienced the highest invasive cervical cancer incidence rates (16.2 per 100,000) of any group other than Vietnamese, and twice the incidence rates of non-Hispanic White women (7.9 per 100,000). (4,7-9)
Even though Hispanic women have lower rates of breast cancer(69.8 per 100,000)compared to non-Hispanic White women or Black women (111.8 and 95.4 respectively), breast cancer is the leading cause of cancer death among Hispanics. (5,7)
Poverty, lack of insurance, low education, limited access to health care, lack of awareness of breast cancer risks and screening methods, physician referrals, acculturation levels and barriers related to language, culture, and negative provider attitudes, play and important role in the lower rates of screening services utilization by Hispanic women. (8,11-14)
Low screening participation rates make Hispanic women more likely to be diagnosed at a more advanced stage of the disease when fewer treatment options are available resulting in poorer outcomes and higer mortality. (8,11, 15)
Age, income, education, health insurance coverage, language proficiency, physician referrals, system barriers, are some of the factors that influence the participation of Hispanic women in the utilization of screening services. Other factors include cultural beliefs about modesty and sexual behavior, fatalism, acculturation factors unrelated to language use, family-centered values, and existing social support networks. The degree to which each Hispanic population group in each locale holds onto beliefs about cancer may play an important role in levels of participation. (8, 11-14)
Cervical cancer risk is high among Latinas,with the incidence rates that are double those of Whites. This risk differential has not appreciably improved over the last decades. Cervical cancer mortality is also markedly higher among Latinas. (10)
The five-year survival rate for non-Hispanic White women with breast cancer is 85% while for Hispanic women it is 76%. (15)
Uninsured Hispanics are two to three times more likely to have cancer diagnosed at a later stage, making it less treatable. Uninsured Hispanic women with breast cancer are 2.3 times more likely to be diagnosed at a later stage while uninsured Hispanic men with prostate cancer are 3.75 times more likely to be diagnosed at a later stage. (18)
Health risk experienced by the uninsured Latino population include a reduced access to care and poorer medical outcomes. The uninsured are less likely to have access to care, less likely to have had a recent physician visit, more likely to delay seeking medical care, more likely to report they have not recieved needed care, and less likely to use preventive services. (18)
2. Ramirez AG, Suarez L. Hispanic cultures, Latinos, Centeral Americans. 2000 in press.
4. American Cancer Society. Cancer facts and figures 1997.
5. National Cancer Institute. Cancer facts: Breast Cancer and Mammography Facts, 1998
6. Susan G. Komen Foundation. Breast Health. Hispanic Women and Breast Cancer 1998
7. Reis LAG, Kosary CL, Hankey BF, Miller BA, Edwards BK, editors. SEER Cancer Statistics Review, 1993-1999. Bethesda, MD: National Cancer Institute, 2000
8. Ramirez AG, Suarez L, McAlister A, Villrreal R, Trapido E, Talavera GA, Perez-Stable E, Marti J. Cervical Cancer Screening in Regional Hispanic Populations. AM J. Health Behav 2000;24(3):181-92.
9. Parker SL, Davis KJ, Wingo PA, Reis LAG, Health CW. Cancer Statistics by Race and Ethnicity. CA Cancer J Clin 1998; 48(1):31-48
11. Ramirez AG, Suarez L. The Impact of Cancer in Latino Population. In: Aguirre-Molina M, Molina C, Zambrana R, editors. Latino Health Book; 2000press.
14. US Department of Health and Human Services. Racial and Ethnic Disparaties in Health. February 21, 1998.
15. Gilliland FD, Hunt WC, Key CR. Trends in the Survival of American Indian, Hispani, and Non-Hispanic White Cancer Patients in New Mexico and Arizona, 1969-1994. Cancer 1998;82(9): 1769-83.
18. American College of Physcicians - American Society of Internal Medicine
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