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.