With the Latino population set to triple by 2050, the already alarming number of cancer diagnoses in the Latino community could rise just as sharply, or even more drastically, according to a new compilation of research.
"I see this as a train wreck that's really waiting to happen," said Lydia Buki, a licensed psychologist and associate professor of community health at the University of Illinois. In a chapter in the recently published Handbook of U.S. Latino Psychology, Buki projects an impending explosion in cancer diagnoses in the Latino population and argues that not enough is being done to combat the coming crisis. "If this is already that big a problem," she said, "imagine when we have more people."
While much of Buki's own work has focused on breast and cervical cancers, her most recent work summarized research on the top four cancers that impact Latinos: breast, cervical, colorectal, and prostate. With the Latino population's projected explosion in the coming decades, Buki said, the number of cancer diagnoses -- though not necessarily the cancer incidence rate -- will also see a troubling rise among Latino men and women.
This is not to say that other communities of color are not dealing with similar threats. For instance, Black men are reported to have the nation's highest prostate cancer rate and some cancer diagnoses are on the rise among Asian women.
But Buki said the risk is especially great for Latinas, who have a lower breast cancer survival rate than whites. Latinas are also dying of cervical cancer, which can often be treated effectively when detected early, at about twice the rate of white women.
Experts point to a complex web of social, environmental and economic factors behind the high cancer incidence and death rates.
A lack of health insurance is one of the top predictors for determining what keeps Latinas from getting cancer screenings, Buki said. Recent data shows that about two in every five Latinos lack health insurance. Under federal and state laws, undocumented immigrants have limited access to care.
Yet, a 2008 report by the Pew Hispanic Center found that just 17 percent of Latinos without a regular health care provider reported a lack of insurance coverage as the main reason. Insurance is not the only answer, said Buki: "This is an interdisciplinary issue."
One study, Buki said, found that social and cultural factors influence Mexican American women's access to breast cancer screening. Women reported feeling uncomfortable when asked to remove their clothes for a doctor's exam or a mammogram. Other Latinas would cancel medical appointments if they found out their doctor was a man. Some would withhold personal medical information during a visit because they were uncomfortable with an interpreter listening in.
Even within their own community Latinos are sometimes hesitant to discuss cancer and other illnesses, researchers say.
Still, although Latinos are sometimes hesitant to seek preventive care and cancer education, other barriers limit their health care options, especially for those who have limited English ability. And limited services mean fewer chances to catch cancer at an early stage, before it becomes deadly.
"There are so many public health departments across the country that don't have staff who are bilingual, that don't go out into the communities," Buki said. "They're not getting the word out." In the midst of the recession, she added, "With all these budget cuts, we see a lot of times, the things that go first are the things for ethnic minorities."
There are few organizations geared specifically toward helping Latinas fight cancer. In a recent study, which has not yet been published, Buki surveyed 40 groups that provide counseling to Latinas about dealing with breast cancer. She found that 80 percent said they had trouble keeping up with demand for services, and about as many groups reported that the community's needs had increased over the past several years.
Dr. Elmer Huerta is on the front lines of preventive care for Latinos. About 15 years ago, Huerta left Peru -- and his oncology career -- to establish at Washington Hospital Center in Washington, D.C., his Cancer Preventorium. The low-cost clinic, which provides all-inclusive screenings for $130, has seen almost 25,000 people -- about 90 percent of them Latinos -- since its inception. Huerta is working with other communities to replicate the model across the country.
To raise community awareness about cancer-related health issues, Huerta hosts five types of radio programs and three television shows, all in Spanish, that educate listeners about disease prevention and early detection. "I want to welcome the immigrant that comes to this country. If they want to succeed in this country, they need to take care of their health," Huerta said. "This is a modelthat uses the media as a tool to educate people and move them from inaction to action."
Buki attributed Huerta's influence among the Latino community in Washington to the overwhelming demand for free mammograms when they were made available in the city through a national program and promoted through Spanish radio. Elsewhere, drawing Latinas to the free screenings was more difficult. "The women need to get the message from someone they trust who understands their culture and speaks in their language," Buki said.
Providing health education through organizations with bilingual and bicultural staff is important, Buki said. The government could build up the medical infrastructure of Latino communities, she said, by training more Spanish-speaking doctors, providing more Spanish-language educational materials and building more clinics in Latino neighborhoods. The cost of these preventive and primary care investments would be offset by a decrease in health care costs in the long term.
In addition to education and stronger healthcare services, much of the battle against cancer in the Latino population starts with community members themselves.
When California-based television reporter Ysabel Duron received a Hodgkin's lymphoma diagnosis in 1998 and decided to turn her inner battle into a three-part television series, she discovered how few of her fellow Latinos were speaking publicly about cancer. Through her series, Duron recalled in a recent interview, she was trying to "take the mystery out" of the frightening disease for other Latinos.
After defeating her cancer and cutting down her on-air hours, Duron saw the need for public education and established Latinas Contra Cancer, a San Jose-based nonprofit that targets underserved and low-income members of the Spanish-speaking community. The organization, which provides cancer prevention education, promotes screenings and aids in patient navigation and support, is also working to link cancer services for Latinos across the country. "What I have tried to do," Duron said, "is bring the Latino voice to the national table."