Cancer survival among Latinos and the Hispanic Paradox

Paulo S. Pinheiro, Melanie Williams, Eric A. Miller, Stephanie Easterday, Sheniz Moonie, Edward J. Trapido

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Background Cancer survival is a key indicator of the effectiveness and social justice of health services. However, little is known about cancer survival among Hispanics, how it varies by Hispanic subgroup (Mexicans, Puerto Ricans, Cubans, and Others), and how their survival patterns relate to the Hispanic Paradox. Methods We studied all 1.2 million cancer cases diagnosed during 1995-2003, in two states, Florida and Texas, according to three categories of outcome: highly fatal outcome, poor outcome, and moderate outcome. All were followed up until December 31, 2006. We calculated survival rates for each Hispanic subgroup, and using Cox regression, we studied the risk of death for each Hispanic subgroup compared with non-Hispanic Whites, adjusted for age, cancer site, and stage at diagnosis. Results Important differences in cancer survival were found according to Hispanic subgroup. For cancers of moderate outcome, the adjusted risk of death was higher among all Hispanic populations in comparison with non- Hispanic Whites: 6% higher for Cubans, 11% for Puerto Ricans, and 13% for US-born Mexicans. Foreign-born Mexicans, even with incomplete follow-up, had a 24% higher risk of death. For foreign-born Hispanics, except Cubans, the mortality follow-up of cancers of highly fatal outcome was insufficient, resulting in missing deaths and thus unrealistically high survival rates. Conclusions No evidence of a Hispanic advantage was found in cancer survival. Improvement in mortality follow- up procedures for Latinos, especially for those without a valid social security number, is critical. By considering Hispanics as a whole rather than by subgroup, existing survival disparities are being missed.

Original languageEnglish (US)
Pages (from-to)553-561
Number of pages9
JournalCancer Causes and Control
Issue number4
StatePublished - Apr 1 2011
Externally publishedYes


  • Cancer survival
  • Florida
  • Hispanic
  • Latino
  • Mortality
  • Paradox
  • Texas

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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