Fax: (717) 531-5779
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 1213–1224, 1 September 2008
How to Cite
Wilson, R. T., Richardson, L. C., Kelly, J. J., Kaur, J., Jim, M. A. and Lanier, A. P. (2008), Cancers of the urinary tract among American Indians and Alaska Natives in the United States, 1999–2004. Cancer, 113: 1213–1224. doi: 10.1002/cncr.23733
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.
- 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;
- United States;
- health disparity
Assessment of the kidney parenchyma (“kidney”) and urinary bladder (“bladder”) cancer burden among American Indians and Alaska Natives (AI/AN) has been limited. Using a database with improved classification for AI/AN, the authors described patterns of these 2 cancers among AI/AN and non-Hispanic whites (NHW) in the United States.
Cases diagnosed during 1999 to 2004 were identified through National Program of Cancer Registries and the Surveillance, Epidemiology and End Results program and linked to the Indian Health Service (IHS) registration records. Age-adjusted incidence rates, rate ratios (RR), annual percent change, and stage at diagnosis were stratified by IHS Contract Health Service Delivery Area (CHSDA) counties to adjust for misclassification.
Kidney cancer incidence among AI/AN in CHSDA counties exceeded that among NHW (RR, 1.51; 95% confidence interval [CI], 1.42-1.61), and was highest among AI/AN in the Northern Plains, Southern Plains, Alaska, and Southwest. Average annual increases were highest among AI/AN (5.9%) and NHW (5.9%) males aged 20 to 49 years, although statistically significant only among NHW. Conversely, bladder cancer incidence was significantly lower among AI/AN than NHW (RR, 0.40; 95% CI, 0.37-0.44). For both sites, AI/AN were significantly less likely to be diagnosed at an earlier stage than NHW.
AI/AN have about 50% greater risk of kidney cancer and half the risk of bladder cancer than NHW. Although reasons for these enigmatic patterns are not known, sustained primary prevention efforts through tobacco cessation and obesity prevention are warranted. Cancer 2008;113(5 suppl):1213–24. Published 2008 by the American Cancer Society.