title: Black Heterogeneity in Cancer Mortality: US-Blacks, Haitians, and Jamaicans.
abstract: BACKGROUND
  The quantitative intraracial burden of cancer incidence, survival and mortality within black populations in the United States is virtually unknown.
  
  
  METHODS
  We computed cancer mortality rates of US- and Caribbean-born residents of Florida, specifically focusing on black populations (United States, Haiti, Jamaica) and compared them using age-adjusted mortality ratios obtained from Poisson regression models. We compared the mortality of Haitians and Jamaicans residing in Florida to populations in their countries of origin using Globocan.
  
  
  RESULTS
  We analyzed 185,113 cancer deaths from 2008 to 2012, of which 20,312 occurred in black populations. The overall risk of death from cancer was 2.1 (95% CI: 1.97-2.17) and 1.6 (95% CI: 1.55-1.71) times higher for US-born blacks than black Caribbean men and women, respectively (P < .001).
  
  
  CONCLUSIONS
  Race alone is not a determinant of cancer mortality. Among all analyzed races and ethnicities, including Whites and Hispanics, US-born blacks had the highest mortality rates while black Caribbeans had the lowest. The biggest intraracial difference was observed for lung cancer, for which US-blacks had nearly 4 times greater mortality risk than black Caribbeans. Migration from the islands of Haiti and Jamaica to Florida resulted in lower cancer mortality for most cancers including cervical, stomach, and prostate, but increased or stable mortality for 2 obesity-related cancers, colorectal and endometrial cancers. Mortality results in Florida suggest that US-born blacks have the highest incidence rate of "aggressive" prostate cancer in the world, rather than Caribbean men.
authors.affiliation: University of Nevada Las Vegas, School of Community Health Sciences, African-Caribbean Cancer Consortium, Las Vegas, NV, USA. paulo.pinheiro@unlv.edu.
authors.forename: Paulo S
authors.initials: PS
authors.lastname: Pinheiro
authors.forename: Karen E
authors.initials: KE
authors.lastname: Callahan
authors.forename: Camille
authors.initials: C
authors.lastname: Ragin
authors.forename: Robert W
authors.initials: RW
authors.lastname: Hage
authors.forename: Tara
authors.initials: T
authors.lastname: Hylton
authors.forename: Erin N
authors.initials: EN
authors.lastname: Kobetz
mesh_terms: D044383:Black People; D005260:Female; D018740:Genetic Heterogeneity; D006205:Haiti; D006801:Humans; D015994:Incidence; D007563:Jamaica; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality*; D015996:Survival Rate; D014481:United States; D001741:Black or African American