Cancer is the second leading cause of death in Hispanic/Latina women in the U.S. Like non-Hispanic white women, the most common sites in Hispanic/Latina women are breast, lung, and colon cancer (1). Table 1 demonstrates the
 

average annual cancer incidence rates for the most common types of cancer for both Hispanic/Latina women and non-Hispanic (NH) White women in the U.S. for 2003. It is important to note that breast and colon cancer are the most prevalent cancers occurring in Hispanic/Latina women, but yet are still not as prevalent as in other racial/ethnic groups. It is important to also note that cervical cancer is more prevalent in Hispanic women in comparison to non-Hispanic White and Black women. Breast and cervical cancer in Hispanic/Latina women will be further addressed in this module.

However, unique to Hispanic/Latina women is the occurrence of stomach, liver and biliary duct cancer. Table 2 and 3 demonstrate cancer incidence rates and death rates for these cancers. Stomach cancer is more common throughout Central and South American than it is in the U.S. For example, incidence rates for women living in Chile are five-fold higher than for women living in the U.S. Overall, the incidence for stomach cancer in the U.S. is at least 70% higher in Hispanics than non-Hispanics whites (1). 
 

Diets rich in smoked foods, salted meat or fish, pickled vegetables and low in fresh vegetables have been associated with an increased risk of stomach cancer. H. pylori infection is another risk factor that has been associated with stomach cancer, and has been found to be more prevalent in patients from lower socioeconomic status, particularly those living in crowded conditions. Annual mortality rates from stomach cancer is significantly higher for Hispanic women than it is for non-Hispanic White women (see Table 3). 
 

Overall, Hispanics experience a two-fold higher incidence and death rate from liver cancer compared to non-Hispanic whites. From 1994 to 2003, death rates from liver cancer have increased by > 2% in Hispanic/Latina women in the U.S. Liver cancer has been demonstrated to be strongly associated with chronic infections of Hepatitis B and Hepatitis C. Alcohol consumption and consumption of aflatoxin-contaminated grains have also been identified as risk factors(2). 

The highest incidence and mortality rates for gallbladder/bile duct cancer are found in Hispanic and Indian populations located in South America (Chile and Bolivia), North American Indians, and Mexican Americans. In these populations, women are diagnosed more often in women than in men. Studies have demonstrated that chronic gallstones are an important risk factor for gallbladder cancer. Chronic gallstones can result from hereditary factors affecting cholesterol secretion in the bile and may be more prevalent in Hispanics. Obesity, hormonal factors and diet have been associated with an increase incidence of gallbladder cancer. The incidence has been shown to be twice the incidence in Hispanics compared to non-Hispanic whites (2).

Let's now turn our attention to two specific types of cancers - cervical and breast cancer. Start with Case 1.

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1. Center for Disease Control and Prevention (2006). National Center for Health Statistics. Accessed on 12/25/2007 at 
http://apps.nccd.cdc.gov/uscs/ .

2. American Cancer Society (2006). Cancer Facts and Figures for Hispanics/Latinos2006-2008, Atlanta, GA.