In the United States, current vaccines will reduce most HPV-associated cancers; a smaller additional reduction would be contributed by the new 9-valent vaccine.

Racial and ethnic differences in age at melanoma diagnosis, anatomic sites, and histologic types suggest variations in etiologic pathways. The high percentages of advanced and thicker melanomas among nonwhites highlight the need to improve melanoma awareness for all race and ethnicity in the United States.

Background:The diversity among Hispanics/Latinos, defined by geographic origin (e.g., Mexico, Puerto Rico, Cuba), has been neglected when assessing cancer morbidity. For the first time in the United States, we estimated cancer rates for Cubans, Mexicans, Puerto Ricans, and other Latinos, and analyzed changes in cancer risk between Hispanics in their countries of origin, U.S. Hispanics in Florida, and non-Hispanic Whites in Florida. Methods: Florida cancer registry (1999-2001) and the 2000 U.S. Census population data were used. The Hispanic Origin Identification Algorithm was applied to establish Hispanic ethnicity and subpopulation. Results: The cancer rate of 537/100,000 person-years (95% confidence interval, 522.5-552.5) for Hispanic males in Florida was lower than Whites (601; 595.4-606.9). Among women, these rates were 376 (365.6-387.1) and 460 (455.6-465.4), respectively. Among Florida Hispanics, Puerto Ricans had the highest rates, followed by Cubans. Mexicans had the lowest rates. Rates for Hispanics in Florida were at least 40% higher than Hispanics in their countries of origin, as reported by the IARC. Conclusion: Substantial variability in cancer rates occurs among Hispanic subpopulations. Cubans, unlike other Hispanics, were comparable with Whites, especially for low rates of cervical and stomach cancers. Despite being overwhelmingly first generation in the U.S. mainland, Puerto Ricans and Cubans in Florida showed rates of colorectal, endometrial, and prostate cancers similar to Whites in Florida. Because rates are markedly lower in their countries of origin, the increased risk for cancer among Cubans, Mexicans, and Puerto Ricans who move to the United States should be further studied. (Cancer Epidemiol Biomarkers Prev 2009;18(8):2162–9)

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BACKGROUND: Determine the effects of race, socioeconomic status, and treatment on outcomes for patients diagnosed with lung cancer. METHODS: The Florida cancer registry and inpatient and ambulatory data were queried for patients diagnosed from 1998-2002. RESULTS: A total 76,086 of lung cancer patients were identified. Overall, 55.6% were male and 44.4% were female. The demographic distribution of patients was 92.7% Caucasian, 6.7% African American, and 5.7% Hispanic. The mean age of diagnosis was 70 years old. African American patients presented at a younger age, with more advanced disease, and were less likely to undergo surgical therapy than their Caucasian counterparts. Median survival time (MST) for the entire cohort was 8.7 months, while MST for African American patients was 7.5 months. Patients who received surgery, chemotherapy, or radiation therapy demonstrated significantly improved outcomes. Stepwise multivariate analysis revealed that African American race was no longer a statistically significant predictor of worse outcomes once corrections were made for demographics and comorbid conditions, suggesting that the originally reported disparities in lung cancer outcomes and race may be in part because of poor pretreatment performance status. In contrast, patients of the lowest socioeconomic status continue to have a slightly worse overall prognosis than their affluent counterparts (hazard ratio ¼ 1.05, P ¼ .001). CONCLU-SIONS: Lung cancer continues to carry a poor prognosis for all patients. Once comorbidities are corrected for, African American patients carry equivalently poor outcomes. Nonetheless, emphasis must be placed on improving pretreatment performance status among African American patients and efforts for earlier diagnosis among the impoverished patients must be made.

Objectives: To assess the relationship between socioeconomic status (SES) and late stage breast cancer using the cluster detection software SaTScan and U.S. census -derived areabased socioeconomic measures. Materials and Methods: Florida's 18,683 women diagnosed with late stage breast cancer (regional or distant stage) between 1998 and 2002 as identified by Florida's population -based, statewide, incidence registry were analyzed by SaTScan to identify areas of higher-than-expected incidence. The relationship between SES and late stage breast cancer was assessed at the neighborhood (block group) level by combining the SaTScan results with area-based SES data. Results: SaTScan identified 767 of Florida's 9,112 block groups that had higher-than-expected incidence of late stage breast cancer. After controlling for patient level insurance status, county level mammography prevalence, and urban/rural residence in the logistic regression model, women living in neighborhoods of severe and near poverty were respectively 3.0 and 1.6 times more likely to live in areas of higher-than-expected incidence of late stage breast cancer when compared with women living in nonpoverty. Additionally, areas in the lowest quartile of mammography usage were almost seven times more likely to have higher-than-expected incidence than areas in the higher quartiles. Conclusions: In addition to confirming the importance of mammography, results from the present study suggest that ''where'' you live plays an important role in defining the risk of presenting with late stage breast cancer. Additional research is urgently needed to understand this risk and to leverage the strengths and resources present in all communities to lower the late stage breast cancer burden. (Cancer Epidemiol Biomarkers Prev 2007;16(4):756 -62)

Objective To determine the baseline prevalence of human papillomavirus (HPV) types in invasive vulvar cancers (IVC) and vulvar intraepithelial neoplasia 3 (VIN3) using data from 7 United States cancer registries. Materials and Methods Registries identified eligible cases diagnosed in 1994–2005 and requested pathology laboratories to prepare one representative block for HPV testing on those selected. Hematoxylin and eosin stained (H&E) sections preceding and following those used for extraction were reviewed to confirm representation. HPV was detected using L1 consensus PCR with PGMY9/11 primers and type specific hybridization, with retesting of negative and inadequate samples with SPF10 primers. For IVC, the confirmatory H&E slides were re-evaluated to determine histologic type. Descriptive analyses were performed to examine distributions of HPV by histology and other factors. Results HPV was detected in 121/176 (68.8%) IVC and 66/68 (97.1%) VIN3 (p<.0001). IVC and VIN3 differed by median age (70 years vs. 55 years, p=.003). HPV16 was present in 48.6% of IVC and 80.9% of VIN3; other high-risk (HR) HPV was present in 19.2% of IVC and 13.2% of VIN3. HPV prevalence differed by squamous cell carcinoma (SCC) histologic subtype (p<.0001): keratinizing, 49.1% (n=55); non-keratinizing, 85.7% (n=14), basaloid, 92.3% (n=14), warty 78.2% (n=55), and mixed warty/basaloid, 100% (n=7). Conclusions Nearly all VIN3 and two-thirds of IVC were HR-HPV positive. HPV prevalence ranged from 49.1–100% across SCC histologic subtypes. Given the high prevalence of HPV in IVC and VIN3, prophylactic vaccines have the potential to decrease the incidence of vulvar neoplasia.

Objective We conducted a baseline study of human papillomavirus (HPV) type prevalence in invasive cervical cancers (ICC) using data from seven cancer registries (CR) in the US. Cases were diagnosed between 1994 and 2005, before the implementation of the HPV vaccines. Materials and Methods CRs from Florida, Kentucky, Louisiana, Michigan, Hawaii, Iowa and Los Angeles, California identified eligible ICC cases, and obtained sections from representative blocks of archived tumor specimens for DNA extraction. All extracts were assayed by Linear Array and if inadequate or HPV negative, re-tested with INNO-LiPA Genotype test. Clinical and demographic factors were obtained from the CRs and merged with the HPV typing data to analyze factors associated with different types and with HPV negativity. Results A total of 777 ICCs were included in this analysis, with broad geographic, age and race distribution. Overall, HPV was detected in 91% of cases, including 51% HPV16, 16% HPV18 (HPV16 negative), and 24% other oncogenic and rare types. After HPV16 and 18, the most common types were 45, 33, 31, 35 and 52. Older age and non-squamous histology were associated with HPV negative typing. Conclusions This study provides baseline pre-vaccine HPV types for post-vaccine ICC surveillance in the future. HPV16 and/or 18 were found in 67% of ICCs, indicating the potential for vaccines to prevent a significant number of cervical cancers.