CONTRASTING TRENDS OF PROSTATE-CANCER INCIDENCE AND MORTALITY IN NEW-MEXICO HISPANICS, NON-HISPANIC WHITES, AMERICAN-INDIANS, AND BLACKS

Background. Prostate cancer has increased in epidemic proportions duri ng the 1980s. Although marked differences in ethnic and racial tempora l trends for prostate cancer have been observed both in the United Sta tes and internationally, the trends in Hispanics and American Indians have not been described extensively. Methods. To characterize the occu rrence of prostate cancer among non-Hispanic whites, Hispanics, Americ an Indians, and blacks in New Mexico, the authors examined cancer inci dence data collected by the New Mexico Tumor Registry for the period 1 969-1991 and mortality data collected by the New Mexico Bureau of Vita l 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 Hispani cs. American Indians had the lowest incidence rates of all groups. Ove r the same period, incidence rates for local-stage cancers increased b y 93% and 81% among non-Hispanic whites and Hispanics, respectively, b ut were stable for American Indians and blacks, whereas rates for regi onal-stage cancers increased sharply. Incidence rates of distant-stage disease decreased among non-Hispanic whites from 1969 through 1991. I n contrast, incidence rates of distant-stage disease among Hispanics i ncreased through 1982. From 1983 to date, age-adjusted mortality rates of prostate cancer decreased among all groups except Hispanics. Concl usion. The patterns of incidence and mortality are consistent with a s tage migration. The recent decrease in age-adjusted prostate cancer mo rtality rates for non-Hispanic whites is consistent with that expected following the decrease in distant-stage disease incidence. Differenti al access to medical care and prostate cancer screening may account fo r these trends.