Abstract Background: Few studies have examined how cancer incidence varies by country of origin among United States Hispanic/Latino adults. Herein, we describe the incidence rates of cancer overall and for screen-detectable, tobacco-related, and obesity-related cancers among 16,415 participants in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), an ongoing population-based cohort study of Hispanic/Latino adults from diverse backgrounds. Methods: Cohort participant records were linked to the state cancer registries in New York, Florida, California, and Illinois to ascertain cancer incidence from baseline (2008-2011) through 2021. We estimated weighted age-adjusted incidence rates (IRs), and age- and sex-adjusted hazard ratios (HRs). Results: Over a mean follow-up of 10.7 (SD=2.0) years, 715 incident invasive cancers were diagnosed including 118 female breast, 102 prostate, and 79 bronchus and lung cancers. The IR of all cancers combined was 26.2 [95% confidence interval (CI)=22.6-30.2] per 10,000 (10K) person-years (py). The IRs were lowest among persons of Mexican descent [IR=19.0 (95%CI=15.0-24.1) per 10K-py] and highest for those of Puerto Rican [IR=36.6 (95%CI=28.4-47.0) per 10K-py] descent. Compared to those of Mexican descent, those of Puerto Rican, Cuban, and Dominican descent had higher hazards of cancer incidence; the incidence of obesity-related (HR=2.37; 95%CI=1.43-3.95) and tobacco-related (HR=3.00; 95%CI=1.58-5.71) cancers were also the highest among Puerto Ricans. Conclusions: Cancer incidence rates varied by Hispanic/Latino heritage and were masked when Hispanics/Latinos were aggregated into a single group. Impact: Understanding disparities in cancer risk by Hispanic/Latino heritage may help tailor cancer prevention and control strategies.

Cancer Incidence in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) – The Onco-SOL Ancillary Study