Demographic and geographic variations in Breast Cancer mortality among US Hispanics

Background: Since 1999, the National Center for Health Statistics has supported the validity of Hispanic ethnic classifications on death certificates. Objective: Describe demographic and geographic variations in Hispanic mortality from malignant neoplasm of the breast among US women ages 35-64 and 65+ years. Methods: Age-adjusted (Year 2000 standard) mortality rates and 95% confidence intervals were obtained from the Compressed Mortality File as presented on the public US Centers for Disease Control and Prevention WONDER internet website. Results: Hispanic mortality was significantly lower than non-Hispanic mortality (35-64: 19.2 (18.8,19.6) versus 29.0 (28.8,29.1)) and 65+: (63.2 (61.7,64.7) versus 112.0 (111.5,112,5). Hispanic mortality in the Midwest Census Region (15.3 (14.0,16.6) for 35-64 and 52.2 (46.4,58.1) for 65+) was significantly lower than that for Hispanics in the Northeast, South, and West. Among 37 states with sufficient numbers of deaths among 35-64 year-olds to meet standards of confidentiality, there was a 3.75-fold difference in Hispanic breast cancer mortality from the highest (25.1 (22.2, 27.9) in NM) to the lowest (6.7 (4.0,10.7) in NC), and a 3-fold difference for persons 65+ in 27 states, from 93.9 (61.9,136.6) in MO to 31.7 (15.6, 56.7) in OR. Consistent differences were not observed by urbanization. In contrast to non-Hispanic blacks, whose mortality was higher than that of non-Hispanic whites, Hispanic blacks had significantly lower mortality than both Hispanic and non-Hispanic whites in both age groups. Conclusions: Despite limitations inherent in death certificate information, epidemiologic variations in breast cancer mortality are extensive and potentially useful for public health planning.