Cancer site–specific disparities in New York, including the 1945–1965 birth cohort's impact on liver cancer patterns

Background: Analyses of cancer patterns by detailed racial/ ethnic groups in the Northeastern United States are outdated. Methods: Using 2008–2014 death data from the populous and diverse New York State, mortality rates and regression-derived ratios with corresponding 95% confidence intervals (CIs) were computed to compare Hispanic, non-Hispanic white (NHW), non-Hispanic black (NHB), Asian populations, and specific Hispanic and NHB subgroups: Puerto Rican, Dominican, South American, Central American, U.S.-born black, and Caribbean-born black. Special analyses on liver cancer mortality, given the higher prevalence of hepatitis C infection among the 1945–1965 birth cohort, were performed. Results: A total of 244,238 cancer-related deaths were analyzed. Mortality rates were highest for U.S.-born blacks and lowest for South Americans and Asians. Minority groups had higher mortality from liver and stomach cancer than NHWs; Hispanics and NHBs also had higher mortality from cervical and prostate cancers. Excess liver cancer mortality among Puerto Rican and U.S.-born black men was observed, particularly for the 1945–1965 birth cohort, with mortality rate ratios of 4.27 (95% CI, 3.82–4.78) and 3.81 (95% CI, 3.45–4.20), respectively. Conclusions: U.S.-born blacks and Puerto Ricans, who share a common disadvantaged socioeconomic profile, bear a disproportionate burden for many cancers, including liver cancer among baby boomers. The relatively favorable cancer profile for Caribbean-born blacks contrasts with their U.S.-born black counterparts, implying that race per se is not an inevitable determinant of higher mortality among NHBs. Impact: Disaggregation by detailed Hispanic and black subgroups in U.S. cancer studies enlightens our understanding of the epidemiology of cancer and is fundamental for cancer prevention and control efforts.