Cancer among American Indians and Alaska Natives in the United States, 1999–2004§

Authors

  • Charles L. Wiggins PhD, MSPH,

    Corresponding author
    1. New Mexico Tumor Registry, University of New Mexico Cancer Center, Albuquerque, New Mexico
    • New Mexico Tumor Registry, MSC-11 6020, 1 University of New Mexico, Albuquerque, New Mexico 87131-0001
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    • Fax: (505) 272-3750

  • David K. Espey MD,

    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 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 Association of Science and Technology Centers, which is a contractor to the Indian Health Service.

  • Judith S. Kaur MD,

    1. Native American Programs, Mayo Clinic, Rochester, Minnesota
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  • Robin Taylor Wilson PhD,

    1. Department of Public Health Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania
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  • Judith Swan MHS,

    1. Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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  • Barry A. Miller PhD,

    1. Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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  • Melissa A. Jim 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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  • Janet J. Kelly MS, MPH,

    1. Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, Alaska
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  • Anne P. Lanier MD, MPH

    1. Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, Alaska
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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.

  • Preparation of this article was supported, in part, by National Cancer Institute (NCI) Contract NO1-PC-35138 and by the University of New Mexico Cancer Center, a recipient of NCI Cancer Support Grant P30-CA118100.

  • §

    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.

Abstract

BACKGROUND.

Cancer incidence rates vary among American Indian and Alaska Native (AI/AN) populations and often differ from rates among non-Hispanic whites (NHWs). However, the misclassification of race for AI/AN cancer cases in central cancer registries may have led to underestimates of the AI/AN cancer burden in previous reports.

METHODS.

Cases diagnosed during 1999 through 2004 were identified from population-based cancer registries in the United States. Age-adjusted rates were calculated for the 25 most common sites for AI/ANs and NHWs. To minimize the misclassification of race, cancer registry records were linked with patient registration files from the Indian Health Service (IHS). Analyses were restricted to Contract Health Service Delivery Area (CHSDA) counties and were stratified by IHS region.

RESULTS.

In CHSDA counties, cancer incidence rates among AI/ANs varied widely by region, whereas rates among NHWs did not. For all cancer sites combined, AI/AN rates were higher than NHW rates among both males and females in the Northern and Southern Plains, and among Alaska Native Females; AI/AN rates were lower than NHW rates in the Southwest, the Pacific Coast, and the East. Lung cancer and colorectal cancer rates for AI/ANs exceeded rates for NHWs in Alaska and the Northern Plains. Rates for stomach, gallbladder, kidney, and liver cancer were higher among AI/ANs than among NHWs overall, in Alaska, in the Plains regions, and in the Southwest.

CONCLUSIONS.

Regional differences in cancer incidence rates among AI/AN populations were not obvious from nationwide data and highlighted opportunities for cancer control and prevention. It is unlikely that such differences areexplained by race misclassification. Cancer 2008;113(5 suppl):1142–52. Published 2008 by the American Cancer Society.

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