Demographic and geographic variations in lung cancer mortality among US Hispanics. 1999-2009

Background: Lung cancer is the leading cause of cancer death among Hispanic men and the second among Hispanic women. Objective: Describe US Hispanic mortality from lung cancer. Methods: Age-adjusted mortality rates, 95% Confidence Intervals, and smoking prevalence were obtained from the CDC‘s public internet web sites. Demographic information was from the US Census. ARC View (hot spot) and SAS® 9.2 (multivariable analysis) software were used for analyses. Results: Hispanic mortality was significantly lower than Non-Hispanic mortality regardless of age, race, census region, state, and rural-urban classification; except for Hispanic Asian/Pacific Islanders residing in the West and in Medium Metropolitan and Non-Metro areas. The Hispanic advantage was particularly great for blacks. There was considerable geographic variation in Hispanic mortality by State and gender. Age-adjusted (ages 25+ years) mortality for Hispanic White women ranged from 64.3 (49.0, 83.0) in Kentucky to 9.1 (5.0, 15.2) in Tennessee. Corresponding state high-low values for men were 72.9 (64.3, 81.5) in Michigan and 19.4 (9.7, 34.8) in Mississippi. Hot-spot, county-based analysis of age-adjusted mortality among Hispanic whites ages 25+ years showed a significant geographic cluster in Central Florida (GiZScore 1.6-2.79 for women and 1.91-3.10 for men). This cluster could not be explained by poverty or smoking prevalence in multivariable analysis. Conclusions: Regardless of socio-demographic classification, Hispanics generally had lower risks of overall lung cancer mortality than non-Hispanics. Asian-Pacific Islanders and Hispanic Whites, however, may have significantly high risk in selected geographic areas. Analytic epidemiologic study is needed to elucidate etiologic factors.