Incidence and mortality rates for colorectal cancer in Puerto Rico and among Hispanics, non-Hispanic whites, and non-Hispanic blacks in the United States, 1998-2002

Cancer. 2009 Jul 1;115(13):3016-23. doi: 10.1002/cncr.24340.


Background: Colorectal cancer (CRC) is the second most commonly diagnosed cancer in Puerto Rico (PR). In the United States, the incidence and mortality rates of CRC have great variation by sex and race/ethnicity. Age-standardized incidence and mortality rates of CRC in PR were assessed and compared with the rates among US Hispanics (USH), non-Hispanic whites (NHW), and non-Hispanic blacks (NHB) in the United States for the period from 1998 through 2002. Incidence and mortality trends and relative differences among racial/ethnic groups by sex and age were determined.

Methods: Age-standardized rates using the world standard population (ASR[World]) were based on cancer incidence and mortality data from the PR Central Cancer Registry and from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program using the direct method. The annual percentage changes (APC) and relative risks (RR) were calculated using Poisson regression models.

Results: During 1998 through 2002, the APC of CRC incidence and mortality increased for men in PR, whereas descending trends were observed for other racial/ethnic groups. Overall period rates indicated that, in both sexes, Puerto Ricans had CRC incidence and mortality rates similar to those for USH, but their rates were lower than those for NHW and NHB. However, Puerto Rican men and women ages 40 years to 59 years had the greatest risk of incidence and mortality compared with their USH counterparts.

Conclusions: Areas of concern include the increasing trends of CRC in PR and the higher burden of the disease among young Puerto Ricans compared with the USH population. The authors concluded that further research should be performed to guide the design and implementation of CRC prevention and education programs in PR.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • African Continental Ancestry Group*
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / ethnology*
  • Colorectal Neoplasms / mortality
  • European Continental Ancestry Group*
  • Female
  • Hispanic Americans*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Puerto Rico / epidemiology
  • Risk
  • United States / epidemiology