Breast cancer incidence among American Indian and Alaska Native women: US, 1999–2004§

Authors

  • Phyllis A. Wingo PhD, MS,

    1. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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    • Phyllis A. Wingo is employed by the Arctic Slope Regional Corporation, Inc., which is a contractor to the Indian Health Service.

  • Jessica King MPH,

    1. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Judith Swan MHS,

    1. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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  • Steven S. Coughlin PhD,

    Corresponding author
    1. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
    • Centers for Disease Control, 4770 Buford Highway NE, Chamblee, GA 30341; MS K55
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    • Fax: (770) 488-4639

  • Judith S. Kaur MD,

    1. Division of Medical Oncology, Mayo Clinic, College of Medicine, Rochester, Minnesota
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  • Julie A. Erb-Alvarez MPH,

    1. Southern Plains Inter-Tribal Epidemiology Center, Oklahoma City, Oklahoma
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  • Jeannette Jackson-Thompson MSPH, PhD,

    1. Missouri Cancer Registry and Department of Health Management and Informatics, University of Missouri-Columbia, Columbia, Missouri
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  • Teshia G. Arambula Solomon PhD

    1. Department of Family and Community Medicine, University of Arizona, Tucson, Arizona
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  • 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 US Government work and, as such, is in the public domain in the United States of America.

Abstract

BACKGROUND.

Breast cancer is a leading cause of cancer morbidity and mortality among American Indian and Alaska Native (AI/AN) women. Although published studies have suggested that breast cancer rates among AI/AN women are lower than those among other racial and ethnic populations, accurate determinations of the breast cancer burden have been hampered by misclassification of AI/AN race.

METHODS.

Cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age-adjusted rates for the diagnosis years 1999 through 2004. Several steps were taken to reduce the misclassification of AI/AN race: linking cases to Indian Health Service (IHS) patient services database, restricting analyses to Contract Health Service Delivery Area counties, and stratifying results by IHS region.

RESULTS.

Breast cancer incidence rates among AI/AN women varied nearly 3-fold across IHS regions. The highest rates were in Alaska (134.8) and the Plains (Northern, 115.9; Southern, 115.7), and the lowest rates were in the Southwest (50.8). The rate in Alaska was similar to the rate among non-Hispanic white (NHW) women in Alaska. Overall, AI/AN women had lower rates of breast cancer than NHW women, but AI/AN women were more likely to be diagnosed with late-stage disease.

CONCLUSIONS.

To the authors' knowledge, this report provides the most comprehensive breast cancer incidence data for AI/AN women to date. The wide regional variation indicates an important need for etiologic and health services research, and the large percentage of AI/AN women with late-stage disease demands innovative approaches for increasing access to screening. Cancer 2008;113(5 suppl):1191–202. Published 2008 by the American Cancer Society.

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