Cancer survival in California Hispanic farmworkers, 1988-2001.
BACKGROUND
Although epidemiologic studies have identified elevated cancer risk in farmworkers for some cancer types, little is known about cancer survival in this population.


OBJECTIVE
To determine if cancer survival differs between a Hispanic farmworker population and the general Hispanic population in California.


METHODS
Hispanic United Farm Workers of America union members and California Hispanics diagnosed from 1988 to 2001 with a first primary cancer were identified from the California Cancer Registry. Kaplan-Meier observed 5-year cause-specific survival rates were calculated, and log-rank tests assessed population differences. Cox proportional hazards models for the most common cancers provided age-, stage-, and year of diagnosis-adjusted hazard ratios.


RESULTS
Observed 5-year cancer-specific survival rates were lower for Hispanic United Farm Workers of America men compared to California Hispanic men for all cancer sites combined (53.7% vs 57.7%, respectively) and colorectal cancer (48.1% vs 60.6%, respectively) and higher for non-Hodgkin's lymphoma (86.7% vs 57.6%, respectively). Only non-Hodgkin's lymphoma survival differences remained significant (P = .021) after adjusting for age and stage at diagnosis. No statistically significant survival differences were detected between United Farm Workers of America and California Hispanic women.


CONCLUSIONS
Although survival was generally similar between United Farm Workers of America members and California Hispanics, lower crude survival among United Farm Workers of America men for all sites combined and colorectal cancer warrants public health measures to address barriers to cancer screening in California's Hispanic farm-working populations. Histology-specific analyses with larger sample sizes are required before reaching conclusions on non-Hodgkin's lymphoma survival differences.
Dodge
Jennifer L
JL
Cancer Registry of Central California/Public Health Institute, Fresno, CA 93710, USA. paul.mills@fresno.ucsf.edu
Mills
Paul K
PK
Riordan
Deborah G
DG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000382:Agricultural Workers' Diseases / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality; D002140:California / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data* / Q000639:trends; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality; D011320:Primary Health Care / Q000458:organization & administration; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data* / Q000639:trends; D019035:Rural Health Services / Q000458:organization & administration* / Q000600:supply & distribution / Q000639:trends; D016019:Survival Analysis