Contrasting trends of prostate cancer incidence and mortality in New Mexico's Hispanics, non-Hispanic whites, American Indians, and blacks

BACKGROUND

Prostate cancer has increased in epidemic proportions during the 1980s. Although marked differences in ethnic and racial temporal trends for prostate cancer have been observed both in the United States and internationally, the trends in Hispanics and American Indians have not been described extensively.

METHODS

To characterize the occurrence of prostate cancer among non-Hispanic whites, Hispanics, American Indians, and blacks in New Mexico, the authors examined cancer incidence data collected by the New Mexico Tumor Registry for the period 1969-1991 and mortality data collected by the New Mexico Bureau of Vital Statistics for the period 1958-1991.

RESULTS

From 1969 to 1991, age-adjusted incidence rates increased from 74.4 to 139.1 per 100,000 (87%) among non-Hispanic whites and from 54.0 to 94.7 (75%) among Hispanics. American Indians had the lowest incidence rates of all groups. Over the same period, incidence rates for local-stage cancers increased by 93% and 81% among non-Hispanic whites and Hispanics, respectively, but were stable for American Indians and blacks, whereas rates for regional-stage cancers increased sharply. Incidence rates of distant-stage disease decreased among non-Hispanic whites from 1969 through 1991. In contrast, incidence rates of distant-stage disease among Hispanics increased through 1982. From 1983 to date, age-adjusted mortality rates of prostate cancer decreased among all groups except Hispanics.

CONCLUSION

The patterns of incidence and mortality are consistent with a stage migration. The recent decrease in age-adjusted prostate cancer mortality rates for non-Hispanic whites is consistent with that expected following the decrease in distant-stage disease incidence. Differential access to medical care and prostate cancer screening may account for these trends.

Mortality among employees of a perfluorooctanoic acid production plant

Perfluorooctanoic acid (PFOA) has been found at low levels (10 to 100 parts per billion) in sera of the general population and at higher levels in occupationally exposed workers. Although PFOA has been reported to be a promoter of rodent hepatocarcinogenesis and to alter reproductive hormones in humans and rodents, there is little information on human health effects associated with PFOA exposure. The present study examined the relationship between PFOA and mortality using a retrospective cohort mortality design. The cohort consisted of 2788 male and 749 female workers employed between 1947 and 1983 at a plant that produced PFOA. The all-causes standardized mortality ratio was .75 (95% confidence interval [CI], .56 to .99) for women and .77 (95% CI, .69 to .86) for men. Among men the cardiovascular standardized mortality rate was .68 (95% CI, .58 to .80) and the all-gastrointestinal diseases was .57 (95% CI, .29 to .99). There was no significantly increased cause-specific standardized mortality ratio for either men or women. Ten years of employment in exposed jobs was associated with a 3.3-fold increase (95% CI, 1.02 to 10.6) in prostate cancer mortality compared to no employment in PFOA production. There were only six prostate cancer deaths overall and four among the exposed workers; thus, the results must be interpreted cautiously. If prostate cancer mortality is related to PFOA, PFOA may increase prostate cancer mortality by altering reproductive hormones in male workers.