Age-standardized incidence and mortality rates of oral and pharyngeal cancer in Puerto Rico and among Non-Hispanics Whites, Non-Hispanic Blacks, and Hispanics in the USA

In the American region, Puerto Rico (PR) has the highest incidence of oral and pharyngeal cancer (OPC), but racial/ethnic differences have never been assessed and compared with other groups in the United States of America (USA). We compared the age-adjusted incidence and mortality rates of OPC betwe...

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Published in:	BMC cancer Vol. 9; no. 129; p. 129
Main Authors:	Suárez, Erick, Calo, William A, Hernández, Eduardo Y, Diaz, Elba C, Figueroa, Nayda R, Ortiz, Ana P
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 28-04-2009 BioMed Central BMC
Subjects:	Adult Age Factors Age factors in disease Aged Aged, 80 and over Black or African American - statistics & numerical data Demographic aspects Distribution Female Hispanic or Latino - statistics & numerical data Humans Incidence Male Middle Aged Mortality Mouth cancer Mouth Neoplasms - ethnology Mouth Neoplasms - mortality Pharyngeal Neoplasms - ethnology Pharyngeal Neoplasms - mortality Puerto Rico Puerto Rico - epidemiology Risk Factors Survival Rate - trends Throat cancer United States United States - epidemiology White People - statistics & numerical data United States Puerto Rico
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Summary:	In the American region, Puerto Rico (PR) has the highest incidence of oral and pharyngeal cancer (OPC), but racial/ethnic differences have never been assessed and compared with other groups in the United States of America (USA). We compared the age-adjusted incidence and mortality rates of OPC between PR and among USA Hispanics (USH), Non-Hispanic Whites (NHW), and Non-Hispanic Blacks (NHB) to assess the burden of this cancer in PR. Analysis of the age-standardized rates (per 100,000) was performed using the direct method with the world standard population (ASR(World)) from 1998-2002. Annual percent change (APC) and Relative Risks (RR) were calculated using the Poisson regression model. The incidence ASR(World) for men in PR was constant (APC approximately 0.0%), in contrast, a decrease was observed among NHW, NHB, and USH men, although only USH showed statistical significance (APC = -4.9%, p < 0.05). In women, the highest increase in incidence (APC = 5.3%) and the lowest decrease in mortality (APC = -1.4%) was observed in PR. The ratio of the ASR(World) showed that in all racial/ethnic groups, men had approximately 2-4 fold increased incidence and mortality risk of OPC than women (p < 0.05). Men in PR had a higher mortality risk (p < 0.05) of OPC as compared to USH, NHW, and NHB; but among women, PR showed a significant excess of mortality only as compared to USH (est. SRR = 1.82, 95% CI = 1.41, 2.33). The overall higher incidence of OPC in men in PR as compared to USH, NHB, and NHW could be explained by the effect of gene-environment interactions. Meanwhile, the higher mortality from OPC in PR suggests limitations in the health-care access within this population. Further research is warranted to elucidate these findings.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1471-2407 1471-2407
DOI:	10.1186/1471-2407-9-129