Survival from Anal Cancer Among Hispanics—Puerto Rico, 2000–2007

Purpose

The incidence of anal cancer is increasing, particularly among HIV and men who have sex with men (MSM) groups. The vast majority of cases are associated with human papillomavirus (HPV), the most common sexually transmitted infection. Epidemiological studies have also documented low survival, which might be linked to lack of appropriate screening, access, and utilization of pertinent health care services. Our objective was to assess the relative survival (1 and 3 years) of anal cancer in Puerto Rico for men and women during the period from 2000–2007.

Methods

All histological types of cancer of anus, anal canal, and anorectum (ICD-O-3 codes C210-C218), except for sarcomas, were included. Relative survival was estimated with the use of life tables from the population of Puerto Rico. In addition, the excess survival was compared by age at diagnosis, histology, and stage (defined as local, regional, or distant), using the Poisson regression model.

Results

The overall 3-year relative survival in Puerto Rico was the same (53 %) for men and women.

Conclusions

Our findings establish baseline survival data for anal cancer in Hispanics from Puerto Rico. Since now, the national guidelines for anal cancer screening and treatment are on their way to be determined; baseline information about survival will allow monitoring the efficacy that standardized screening programs may eventually have in increasing anal cancer survival in this population.     

Knowledge of Viral Hepatitis Among Puerto Rican Adults: Implications for Prevention

Although primary prevention of HAV and HBV can be achieved through vaccination, the burden of HCV can only be reduced through behavioral interventions to reduce its risk factors. This study evaluated knowledge regarding transmission, clinical manifestations and prevention of viral hepatitis in Puerto Rico. We assessed the level of knowledge about HAV (six questions), HBV (12 questions) and HCV (eight questions) among non-institutionalized Puerto Rican adults aged 21-64?years. Demographic characteristics and self-reported knowledge of these infections were determined through a face-to-face interview. A mean knowledge score was computed by summing correct responses to each scale. Mean knowledge scores according to demographics were compared using ANOVA or the Kruskal-Wallis test. Mean knowledge scores for HAV, HBV and HCV infections were 2.6?±?1.5, 6.1?±?2.4, and 3.6?±?1.1, respectively. For HAV and HBV infections, the mean knowledge score significantly (P?相似文献   

Peer Reviewed: Awareness of Direct-to-Consumer Genetic Tests and Use of Genetic Tests Among Puerto Rican Adults, 2009

Introduction

Genetic testing remains low among racial/ethnic minority populations in the United States. We aimed to determine the prevalence and correlates of awareness of direct-to-consumer (DTC) genetic tests and the prevalence of genetic test use in a population-based sample of adults in Puerto Rico.

Methods

We analyzed data from adults aged 18 years or older who completed information on genetic test awareness (n = 611; 96% of study population) from the Health Information National Trends Survey conducted in Puerto Rico in 2009. Odds ratios with 95% confidence intervals were estimated by using logistic regression models to identify factors associated with awareness of DTC genetic tests.

Results

The majority of respondents (56%) were aware of direct-to-consumer genetic tests, and approximately 4% had ever undergone any genetic test. Respondents who had never been married were less likely to be aware of DTC tests, as were current smokers. Respondents who ever sought cancer information were more likely to be aware of these tests.

Conclusion

We provide the first published data on the awareness of DTC genetic tests and on use of genetic testing in Puerto Rico. Forty-four percent of our sample of Puerto Rican adults were unaware of direct-to-consumer genetic tests. Given the lack of clear benefits of DTC genetic tests to the general population, educational interventions should be developed to increase awareness and specific knowledge regarding the appropriate use of DTC genetic tests among people who are already aware of their existence.     

Assessing Colorectal Cancer Knowledge Among Puerto Rican Hispanics: Implications for Cancer Prevention and Control

In Puerto Rico, colorectal cancer (CRC) incidence and mortality rates are increasing. Moreover, adherence rates to CRC screening (52.2%) are still below the goals (70.5%) established by Healthy People 2020. Lack of knowledge is described as a significant barrier to adherence to CRC screening. The aim of this study was to assess CRC knowledge and screening rates among Puerto Rican Hispanics. Participants aged 40–85 years were recruited from the internal medicine outpatient clinics at the University of Puerto Rico. Demographic characteristics and knowledge about CRC, including risk factors and CRC screening tests, were obtained through face-to-face interviews. A mean CRC knowledge score was calculated based on correct responses to 13 validated questions. Mean knowledge scores were evaluated according to demographic characteristics using the Wilcoxon-Mann-Whitney test. A total of 101 participants were recruited with mean age of 63 (±10.6) years. Fifty-eight (58%) of participants were females, 59% reported ≥12 years of education, and 71% reported ever screening for CRC. The mean CRC knowledge score was significantly lower (p?<?0.05) among participants with lower annual family income, those who had never received a recommendation for CRC screening by a healthcare provider, and those who had no history of CRC screening. Knowledge about CRC must be improved in Puerto Rico. Efforts must be made to promote and develop culturally appropriate CRC educational strategies. Future studies should focus on identifying other barriers and factors that may limit CRC screening in the Puerto Rican Hispanic population.     

Risk of thyroid cancer among Caribbean Hispanic patients with familial adenomatous polyposis

Familial adenomatous polyposis (FAP) is an inherited form of colorectal cancer characterized by hundreds of adenomatous polyps in the colon and rectum. FAP is also associated with thyroid cancer (TC), but the lifetime risk is still unclear. This study reports the standardized incidence ratio (SIR) of TC in Hispanic FAP patients. TC incidence rates in patients with FAP between the periods of January 1, 2006 to December 31, 2013 were compared with the general population through direct database linkage from the Puerto Rico Central Cancer Registry (PRCCR) and the Puerto Rico Familial Colorectal Cancer Registry (PURIFICAR). The study population consisted of 51 Hispanic patients with FAP and 3239 with TC from the general population. The SIR was calculated using the Indirect Method, defined as observed TC incidence among patients with FAP in PURIFICAR’s cohort (2006–2013) divided by the expected TC incidence based on the PR population rates (2006–2010). SIR values were estimated by sex (male, female, and overall). This study received IRB approval (protocol #A2210207). In Hispanic patients with FAP, the SIR (95 % CI) for TC was 251.73 (51.91–735.65), with higher risk for females 461.18 (55.85–1665.94) than males 131.91 (3.34–734.95). Hispanic FAP patients are at a high risk for TC compared to the general population. Our incidence rates are higher than previous studies, suggesting that this community may be at a higher risk for TC than previously assumed. Implementation of clinical surveillance guidelines and regular ultrasound neck screening in Hispanic FAP patients is recommended.     

Incidence and mortality rates of selected infection-related cancers in Puerto Rico and in the United States

Background  

In 2002, 17.8% of the global cancer burden was attributable to infections. This study assessed the age-standardized incidence and mortality rates of stomach, liver, and cervical cancer in Puerto Rico (PR) for the period 1992-2003 and compared them to those of Hispanics (USH), non-Hispanic Whites (NHW), and non-Hispanic Blacks (NHB) in the United States (US).     

Seroepidemiology of viral hepatitis,HIV and herpes simplex type 2 in the household population aged 21-64 years in Puerto Rico

Background  

Viral hepatitis and sexually transmitted infections (STIs) are key public health problems that pose an enormous risk for disease transmission in the general population. This study estimated, for the first time, prevalence estimates of serologic markers of HCV, HBV, HAV, HIV and HSV-2 in the adult population of Puerto Rico and assessed variations across sociodemographic and behavioral characteristics.     

Sexual behaviors among adults in Puerto Rico: a population-based study

IntroductionGiven changes in sexual behaviors and norms in the United States, there is a need for current and representative data on sexual behaviors with particular interest in gender, age, and racial/ethnic group differences.AimGiven the limited data for Hispanics and for Puerto Rico (PR), we described patterns of sexual behaviors and characteristics among a sexually active sample (n = 1,575) of adults aged 21–64 years in PR.Main Outcome MeasuresThe main outcome measures for this study are sexual behaviors including age at sexual initiation, number of sexual partners, vaginal and anal intercourse, and oral sex, among others.MethodsData from a population‐based cross‐sectional study in PR (2005–2008) was analyzed. The prevalence of sexual behaviors and characteristics was described by age‐group and gender during the lifetime and in the past 12 months.ResultsOverall, 96.8%, 81.6%, and 60.9% of participants had ever engaged in vaginal, oral and anal sex, respectively, whereas 23.7% were seropositive to any of the sexually transmitted infections under study. Sexual initiation ≤15 years was reported by 37.8% of men and 21.4% of women; whereas 47.9% of men and 13.2% of women reported to have had ≥7 sexual partners in their lifetime. Approximately, 3% of women and 6% of men reported same‐sex sexual practices, while history of forced sexual relations was reported by 9.6% of women and 2.5% of men. Sexual initiation ≤15 years was more common among individuals aged 21–34 years (41.4% men and 33.6% women) as compared with older cohorts. Although having had ≥7 sexual partners over a lifetime among men was similar across age groups, this behavior decreased in older women cohorts. In both genders, the prevalence of oral and anal sex was also lower in the older age cohorts.ConclusionThis study provides essential information that can help health professionals understand the sexual practices and needs of the population of PR. Ortiz AP, Soto‐Salgado M, Suárez E, del Carmen Santos‐Ortiz M, Tortolero‐Luna G, and Pérez CM. Sexual behaviors among adults in Puerto Rico: A population‐based study. J Sex Med 2011;8:2439–2449.