Incidence of cancers of the oral cavity and pharynx among American Indians and Alaska Natives, 1999–2004§

Authors

  • Marsha E. Reichman PhD,

    Corresponding author
    1. Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
    • Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 6116 Executive Boulevard, Suite 504, Bethesda, MD 20892
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    • Fax: (301) 480-4077

  • Janet J. Kelly MS, MPH,

    1. Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, Alaska
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  • Carol L. Kosary MA,

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

    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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  • 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
    2. Division of Epidemiology and Disease Prevention, Indian Health Service, Albuquerque, New Mexico
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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.

  • 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.

Previous studies identified disparities in incidence rates of cancers of the oral cavity and pharynx between American Indians/Alaska Natives (AI/AN) and non-Hispanic whites (NHW) and differences between various AI/AN populations. Reporting among AI/AN has been hampered by: 1) heterogeneity among various anatomic sites of oral cavity and pharyngeal cancers obscuring unique patterns of individual anatomic sites; 2) race misclassification and underreporting of AI/AN; and 3) sparseness of data needed to identify regional variations.

METHODS.

To improve race classification of AI/AN, data from US central cancer registries were linked with Indian Health Service (IHS) records. AI/AN incidence data from 1999 to 2004 were stratified by sex, age, stage at diagnosis, and anatomic subsite for 6 IHS geographic regions and compared with NHW populations.

RESULTS.

For all oral cavity and pharynx cancers combined, among residents of Contract Health Service Delivery Area counties, AI/AN overall had significantly lower incidence rates than NHW (8.5 vs 11.0). However, AI/AN rates were significantly higher in the Northern Plains (13.9 vs 10.5) and Alaska (16.3 vs 10.6), significantly lower in the Pacific Coast (7.7 vs 11.6) and Southwest (3.3 vs 10.4), and similar in the Southern Plains (11.4). Overall AI/AN males had higher incidence rates than AI/AN women. Nasopharyngeal cancer was more frequent (1.1AI/AN vs 0.4 NHW), and tongue cancer less frequent (1.6 AI/AN vs 2.9 NHW) in AI/AN than NHW populations; however, rates varied by region. Stage distribution was modestly less favorable for AI/AN compared with NHW populations.

CONCLUSIONS.

Variation by region, anatomic site, and sex indicates a need for research into etiologic factors and attention to regional risk factor profiles when planning cancer control programs. Cancer 2008;113(5 suppl):1256–65. Published 2008 by the American Cancer Society.

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