Childhood Cancer Risk in Hispanic Enclaves in California

Residence in Hispanic enclaves may be a proxy measure of acculturation. Since acculturation among Hispanic women has been associated with unhealthy behaviors in pregnancy and adverse birth and child health outcomes, we assessed whether living in Hispanic enclaves during pregnancy affects childhood cancer risk among Hispanics. Cancer cases (n = 6,111) were identified from the California Cancer Registry between 1988 and 2013. Control children (n = 124,443) were randomly selected from California birth records. Data from the US decennial census (1990, 2000), and the American Community Survey (ACS) from 2007 to 2011 was used to create an index measure of Hispanic enclaves by census tract. In multivariable logistic regression models, we estimated the effects of living in Hispanic enclaves on cancer risk among young Hispanic children overall and by maternal nativity. We found positive associations between rhabdomyosarcoma in offspring and maternal residence in the least enclave-like tracts [OR = 1.62, 95% CI: (1.06, 2.46)]. For children of foreign-born Hispanic mothers, residence in the least enclave-like tracts was associated with lower retinoblastoma odds [OR = 0.59, 95% CI: (0.38, 0.91)]. In Los Angeles County, residing in the least enclave-like neighborhoods was positively associated with rhabdomyosarcoma and Wilms' tumor odds [OR = 2.71, 95% CI: (1.27, 5.79), OR = 2.23, 95% CI: (1.26, 3.94), respectively]. Overall residence in Hispanic enclaves did not have a uniformly beneficial effect, rather living outside of these enclaves was associated with lower odds of certain childhood cancers. However, there was substantial variation in risk by maternal nativity status and county of residence.