Fax: (505) 248-4393
Article first published online: 20 AUG 2008
Published 2008 American Cancer Society
Supplement: An Update on Cancer in American Indians and Alaska Natives, 1999–2004
Volume 113, Issue Supplement 5, pages 1120–1130, 1 September 2008
How to Cite
Espey, D. K., Wiggins, C. L., Jim, M. A., Miller, B. A., Johnson, C. J. and Becker, T. M. (2008), Methods for improving cancer surveillance data in American Indian and Alaska Native populations. Cancer, 113: 1120–1130. doi: 10.1002/cncr.23724
This supplement was sponsored by Cooperative Agreement Number U50 DP424071-04 from the Centers for Disease Control and Prevention, Division of Cancer Prevention and Control.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
This article is a U.S. Government work and, as such, is in the public domain in the United States of America.
- Issue published online: 20 AUG 2008
- Article first published online: 20 AUG 2008
- Manuscript Accepted: 3 JUN 2008
- Manuscript Received: 5 MAY 2008
- American Indian;
- Alaska Native;
- National Program of Cancer Registries;
- End Results;
- United States;
- health disparity
The misclassification of race decreases the accuracy of cancer incidence data for American Indians and Alaska Natives (AI/ANs) in some central cancer registries. This article describes the data sources and methods that were used to address this misclassification and to produce the cancer statistics used by most of the articles in this supplement.
Records from United States cancer registries were linked with Indian Health Service (IHS) records to identify AI/AN cases that were misclassified as non-AI/AN. Data were available from 47 registries that linked their data with IHS, met quality criteria, and agreed to participate. Analyses focused on cases among AI/AN residents in IHS Contract Health Service Delivery Area (CHSDA) counties in 33 states. Cancer incidence and stage data were compiled for non-Hispanic whites (NHWs) and AI/ANs across 6 IHS regions of the United States for 1999 through 2004.
Misclassification of AI/AN race as nonnative in central cancer registries ranged from 85 individuals in Alaska (3.4%) to 5297 individuals in the Southern Plains (44.5%). Cancer incidence rates among AI/ANs for all cancers combined were lower than for NHWs, but incidence rates varied by geographic region for AI/ANs. Restricting the rate calculations to CHSDA counties generally resulted in higher rates than those obtained for all counties combined.
The classification of race for AI/AN cases in cancer registries can be improved by linking records to the IHS and stratifying by CHSDA counties. Cancer in the AI/AN population is clarified further by describing incidence rates by geographic region. Improved cancer surveillance data for AI/AN communities should aid in the planning, implementation, and evaluation of more effective cancer control and should reduce health disparities in this population. Cancer 2008;113(5 suppl):1120–30. Published 2008 by the American Cancer Society.