Prostate cancer incidence and mortality among Puerto Ricans: an updated analysis comparing men in Puerto Rico with US racial/ethnic groups.

OBJECTIVE Prostate cancer is the most common cancer and the most common cause of cancer death among men in Puerto Rico (PR). Socioeconomic and racial/ethnic disparities with regard to prostate cancer incidence have been reported in the United States of America (US); however, detailed information regarding health disparities in PR is scarce. METHODS Age-standardized rates for prostate cancer incidence and mortality were calculated based on the world standard population using data from the PR Central Cancer Registry and the National Cancer Institute SEER program. The age-specific relative risks were calculated using Poisson regression models. In addition, incidence and mortality rates in PR were compared by socioeconomic position (SEP) at the municipal level. RESULTS For the period from 1992 to 2004, the incidence and mortality trends of prostate cancer decreased in all racial/ethnic groups except for PR men and US Hispanics (USH). Non-Hispanic whites (NHW), non-Hispanic blacks (NHB), and USH had higher incidence of prostate cancer than did PR men; however, PR men aged 85+ yrs and USH aged 45-54 yrs/85+ yrs, respectively, had higher incidences than did NHW and USH. Nonetheless, men in PR had a higher mortality than did USH and NHW. PR men aged 55-64 years with the highest SEP had a 40% higher mortality of prostate cancer than did those with the lowest SEP. CONCLUSION Areas of concern include the higher mortality of prostate cancer in PR as compared with the USH and NHW in the US. Further research should be performed to guide the design and implementation of prostate cancer prevention and education programs that can increase early detection in PR men.

[1]  Rui Mei,et al.  Recent genetic selection in the ancestral admixture of Puerto Ricans. , 2007, American journal of human genetics.

[2]  A. Neugut,et al.  Cancer Incidence and Mortality in the Caribbean , 2007, Cancer investigation.

[3]  T. Rohan,et al.  Cancer disparities between mainland and island Puerto Ricans. , 2009, Revista panamericana de salud publica = Pan American journal of public health.

[4]  C. Muir,et al.  International Classification of Diseases for Oncology , 1990 .

[5]  R. Mei,et al.  A genomewide admixture mapping panel for Hispanic/Latino populations. , 2007, American journal of human genetics.

[6]  E. Feuer,et al.  Permutation tests for joinpoint regression with applications to cancer rates. , 2000, Statistics in medicine.

[7]  Jarvis T. Chen,et al.  Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence: does the choice of area-based measure and geographic level matter?: the Public Health Disparities Geocoding Project. , 2002, American journal of epidemiology.

[8]  J. Witte,et al.  Socioeconomic status and prostate cancer incidence and mortality rates among the diverse population of California , 2009, Cancer Causes & Control.

[9]  D. Hewett‐Emmett,et al.  Origins of u.s. Hispanics: Implications for Diabetes , 1991, Diabetes Care.

[10]  Ahmedin Jemal,et al.  Cancer Disparities by Race/Ethnicity and Socioeconomic Status , 2004, CA: a cancer journal for clinicians.

[11]  Mariela Torres-Cintrón,et al.  Incidence trends of cervical cancer in Puerto Rico, 1987-2004. , 2010, Puerto Rico health sciences journal.

[12]  P. Diggle Applied Spatial Statistics for Public Health Data , 2005 .

[13]  Kathryn L O'Brien,et al.  Cancer Statistics for Hispanics, 2003 , 2003, CA: a cancer journal for clinicians.

[14]  T. Reynolds Report examines association between cancer and socioeconomic status. , 2003, Journal of the National Cancer Institute.

[15]  A. Jemal,et al.  Cancer Statistics, 2008 , 2008, CA: a cancer journal for clinicians.

[16]  A. P. Ortiz,et al.  Productivity loss in Puerto Rico's labor market due to cancer mortality. , 2010, Puerto Rico health sciences journal.

[17]  D. Kleinbaum,et al.  Applied Regression Analysis and Other Multivariate Methods , 1978 .

[18]  T. Rebbeck,et al.  Ethnic Differences in the Frequency of Prostate Cancer Susceptibility Alleles at SRD5A2 and CYP3A4 , 2002, Human Heredity.

[19]  Y. Taylor,et al.  Patterns in prostate-specific antigen test use and digital rectal examinations in the Behavioral Risk Factor Surveillance System, 2002-2006. , 2009, Journal of the National Medical Association.

[20]  A. Jemal,et al.  Global Cancer Statistics , 2011 .

[21]  B. Konety,et al.  Prostate cancer screening: issues and controversies. , 2010, Minnesota medicine.

[22]  T. Guthrie,et al.  Prostate cancer. , 2020, American family physician.

[23]  J. Ferlay,et al.  Global Cancer Statistics, 2002 , 2005, CA: a cancer journal for clinicians.

[24]  H. Howe,et al.  Patterns of cancer incidence among US Hispanics/Latinos, 1995–2000 , 2006, Cancer Causes & Control.

[25]  Ram C Tiwari,et al.  Efficient interval estimation for age-adjusted cancer rates , 2006, Statistical methods in medical research.

[26]  E. Suárez-Pérez,et al.  Incidence and mortality of the leading cancer types in Puerto Rico: 1987-2004. , 2010, Puerto Rico health sciences journal.

[27]  E. Suárez-Pérez,et al.  Using a Socioeconomic Position Index to Assess Disparities in Cancer Incidence and Mortality, Puerto Rico, 1995-2004 , 2011, Preventing chronic disease.

[28]  Z. Frías,et al.  Cancer incidence in the United States and Puerto Rico. , 1975, Cancer research.

[29]  P. Trott,et al.  International Classification of Diseases for Oncology , 1977 .

[30]  Xiaocheng Wu,et al.  Annual report to the nation on the status of cancer, 1975–2003, featuring cancer among U.S. Hispanic/Latino populations , 2006, Cancer.

[31]  C. Pérez,et al.  Incidence and mortality rates of selected infection-related cancers in Puerto Rico and in the United States , 2010, Infectious Agents and Cancer.

[32]  I. Martinez,et al.  [Experience with the cancer registry in Puerto Rico]. , 1991, Boletin de la Asociacion Medica de Puerto Rico.

[33]  A. Jemal,et al.  Cancer Statistics, 2010 , 2010, CA: a cancer journal for clinicians.

[34]  E. Feuer,et al.  Changing area socioeconomic patterns in U.S. cancer mortality, 1950-1998: Part I--All cancers among men. , 2002, Journal of the National Cancer Institute.