If you’re Latino, you could be at risk for colorectal cancer. But the degree of that risk could depend on whether your ancestry traces to Puerto Rico or to Mexico or another Latin American country.

A paper published in the September issue of Current Epidemiology Reports discusses the health implications of classifying Latinos as a homogeneous entity while analyzing existing research about their cancer risks and outcomes and those of various subpopulations.

“For Latinos, we’ve been studying them as one group,” said co-author Mariana Stern, an associate professor of preventive medicine and urology at the University of Southern California. “Now the idea is, let’s acknowledge the fact that we’re not all the same.”

Compared with whites and blacks, Latinos generally have a higher incidence of cervical, penile and gastrointestinal cancers, including those of the gallbladder and liver, according to the report. But they have lower rates of some of the most common forms of the disease, such as breast, lung, colorectal and prostate cancers.

A different picture emerges, however, when researchers examined Latinos based on their family’s place of origin. For example, in Florida, Puerto Ricans and Cubans have higher rates of breast cancer than do Mexicans. And with colorectal cancer there, rates for Cuban and Puerto Rican men were twice that for Mexican men, according to the report. The opposite was true with prostate cancer, with Mexican men having a lower incidence than Cubans and Puerto Ricans.

There are reasons for the variations. Puerto Ricans and Cubans are more likely to have African ancestry, while Mexicans have more Native American roots. These genealogical differences, as well as differences in diet and lifestyle, influence cancer risks, Stern said.

“Because of the diversity within Latinos, we have to understand the diversity so that we can really provide precision medicine to Latinos, as well as other racial groups,” Stern said.

Stern said that doctors have been cautioned in recent years about profiling their patients, which may make many hesitant to ask questions about Latinos’ place of origin during their medical appointments. Yet that information might be very important in determining a patient’s risk factors for certain cancers, she said.

The nation’s 55 million Latinos are the largest and fastest-growing minority group, comprising 17 percent of the population as of 2014. That percentage is expected to double by 2050, according to the report.

“A better understanding of the heterogeneity that exists within Latinos may give important clues regarding the key cancer determinants and cancer characteristics in this population and help achieve the goal of personalized medicine in this fast growing minority group,” according to the report.

Read more: