Preface

Amelie G. Ramirez, DrPH, UT Health San Antonio

Edward J. Trapido, ScD, FACE, LSU Health Science Center

Part 1: Introduction

Ch 1: What Is the Science of Cancer in Latinos?

Eliseo J. Perez-Stable, MD, National Institute on Minority Health & Health Disparities

Part 2: Genetics, Environment, Lifestyle, and Cancer

Ch 2: 21st-Century Cancer Patterns Among Latinos─Why Disaggregation Matters

Paulo S. Pinheiro, MD, PhD, University of Nevada Las Vegas

The cancer burden of Latinos in the U.S. has doubled in 15 years, with 124,000 deaths in 2014. As the relatively young Latino population ages, their cancer burden will inevitably increase. Accurate characterization of the Latino cancer experience is critical. Latinos are heterogeneous, with varying socioeconomic circumstances, nativity and/or immigration experiences, and cultural values and practices, which all impact cancer risk factors and outcomes. While disaggregated incidence and survival profiles for subgroups─Puerto Ricans, Mexicans, Cubans, Central Americans, South Americans, Dominicans─are problematic under the existing cancer surveillance systems, cancer mortality data can be an important source of more accurate granular evidence.

Our research shows that cancer patterns by subgroup can be quite distinct, particularly among first-generation immigrants, according to country of origin. However, patterns tend to become more homogenous for second-generation Latinos and beyond, with an increased burden, for certain cancers across subgroup affiliation, such as U.S.-born Mexicans in California and Puerto Ricans born in New York. Birthplace (U.S. vs. foreign-born), used as a proxy measure of acculturation, is a strong confounder in epidemiological analyses, dramatically influencing cancer patterns. In this context, the examples of colorectal and liver cancers are intriguing. Studying these patterns, often parallel to those of other U.S. minority groups disproportionately impacted by low socioeconomic status such as Native Americans and non-Hispanic blacks, sheds light on the impact of negative acculturation. Here we summarize the findings from several studies on Latino subgroups, addressing the so-called "Hispanic Paradox" and the "Healthy Immigrant Effect"; suggest future research directions; and highlight how these analyses should frame efforts to formulate cancer prevention and control strategies in the burgeoning U.S. Latino population.

Ch 3: Early Onset Colorectal Cancer Among Latinos: Genetics vs. Environment

Marcia R. Cruz-Correa, MD, PhD, University of Puerto Rico

Part 3: Cancer Risk, Prevention, and Screening

Ch 4: Breast Cancer Risk in Hispanics/Latinas: A Panoramic View

Laura Fejerman, PhD, University of California San Francisco

U.S. Hispanic/Latina women (Latinas) and Latin American women have a lower incidence of breast cancer than Non-Hispanic White (NHW) and African American women, but higher incidence of hormone receptor negative tumors and lower breast cancer survival than NHW women. This general statement breaks down when Latina women are stratified into subgroups based on birthplace, country of origin, and region within countries or genetic ancestry. For example, the incidence of breast cancer in Puerto Ricans and Cubans in the U.S. is higher than that of African Americans, which is not the case for Mexican-American women who have a relatively low incidence. Among Latinas in California, those of Caribbean origin have lower breast cancer survival than those from Central or South America. Studies in Colombia and Peru have shown that the prevalence of triple negative breast cancer varies between regions within those countries. In general, higher European genetic ancestry is associated with higher breast cancer risk, and higher African ancestry is associated with higher risk of h