Abstract
Population age structure may confound the comparison of age at cancer diagnosis across racial/ethnic groups. We compared age at cancer diagnosis for U.S. Hispanics, a population that is younger on average, and non-Hispanic whites (NHW), before and after adjustment for the age structure of the source population.
We used Surveillance, Epidemiology, and End Results data from 18 U.S. regions in 2015 for 34 cancer sites to calculate crude and adjusted (using age- and sex-specific weights) mean ages at diagnosis. Differences in age at diagnosis comparing Hispanics to NHWs (δ) were assessed using independent sample t tests.
Crude mean ages at diagnosis were lower among Hispanic males and females for all sites combined and for most cancer sites. After age-adjustment, Hispanic (vs. NHW) males remained younger on average at diagnosis of chronic myeloid leukemia [δ = −6.1; 95% confidence interval (CI), −8.1 to −4.1 years], testicular cancer (δ =−4.7; 95% CI, −5.4 to −4.0), Kaposi sarcoma (δ =−3.6; 95% CI,−6.3 to −0.8), mesothelioma (δ =−3.0; 95% CI,−4.3 to −1.7), and anal cancer (δ =−2.4; 95% CI, −3.9 to −0.8), and older at diagnosis of gallbladder cancer (δ = +3.8; 95% CI, 1.8 to 5.7) and Hodgkin's lymphoma (δ = +7.5; 95% CI, 5.7 to 9.4), and Hispanic (vs. NHW) females remained younger at diagnosis of mesothelioma (δ = −3.7; 95% CI, −6.7 to −0.7) and gallbladder cancer (δ = −3.0; 95% CI, −4.3 to −1.7) and older at diagnosis of skin cancer (δ = +3.8; 95% CI, 3.1 to 4.5), cervical cancer (δ = +4.1; 95% CI, 3.3 to 4.8), and Hodgkin's lymphoma (δ = +7.0; 95% CI, 5.0 to 9.1).
On average, Hispanics are diagnosed with cancer at younger ages than NHWs; however, for many cancers these differences reflect the younger age structure in Hispanics.
Population age structure should be considered when comparing age at cancer diagnosis across racial/ethnic groups.