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INTRODUCTION

Internal malignancies can result in cutaneous paraneoplastic syndromes that may precede the diagnosis of the malignancy or herald a relapse. Awareness of these paraneoplastic syndromes can result in earlier diagnosis of internal malignancy. As discussed in this chapter, people with skin of color present later to the healthcare system with internal malignancies and therefore have a poorer prognosis.1 Based on data in the United States, this chapter will cover the epidemiology of malignancy by race and ethnicity, as well as characteristics of paraneoplastic dermatoses.

EPIDEMIOLOGY

African Americans

In the United States, African Americans have the highest death rates and the shortest survivals for the majority of cancers. Research is still ongoing to determine if these health disparities are due to discrepancies in access to healthcare or other factors.1 Cancer is the second leading cause of death in African Americans. From 2005 to 2009, the death rate for all cancers combined was 33% higher among African American men and 17% higher among African American women when compared to their Caucasian counterparts.1 The most common types of cancer among African American women are breast (33%), lung (13%), and colorectal (11%) cancers.1 The most common types of cancer among African American men are prostate (37%), lung (14%), and colorectal (10%) cancers.1

Cancer deaths among African Americans are primarily due to lung cancer, followed by prostate and colorectal cancers in men, and breast and colorectal cancers in women. Racial discrepancies in cancer death rates are mainly due to breast and colorectal cancers in women and prostate, lung, and colorectal cancers in men. The discrepancies are due to higher incidence among African Americans and shorter survival due to diagnosis at a later stage coupled with decreased access to treatment.

Hispanics/Latinos

Cancer was the leading cause of death in the Hispanic/Latino population in 2009; however, the incidence and death rates for all cancers combined are lower in Hispanics when compared to non-Hispanic whites.2 Malignancies that have higher incidence and mortality in this population include stomach, liver, cervix, and gallbladder cancer.

The most common malignancies among Hispanic men are prostate (29%), colorectal (11%), lung (9%), kidney (6%), and liver (6%) cancers, with lung cancer causing the most cancer deaths, followed by colorectal, liver, and prostate cancers.2 Among Hispanic women, the most common malignancies are breast (29%), colorectal (8%), thyroid (8%), and lung (7%) cancers, with breast cancer accounting for the most cancer deaths, followed by lung and colorectal cancers.2 Although Hispanics/Latinos have lower incidence and death rates, they are more likely to present with more advanced disease than non-Hispanic whites.

Asian Americans and Pacific Islanders

Asian Americans and Pacific Islanders have a lower incidence rate than the non-Hispanic white population for the most common cancers. This population has a higher ...

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