Lung cancer incidence among American Indians and Alaska Natives in the United States, 1999–2004§

Authors

  • Anne Bliss MPH,

    1. Chronic Disease Services, Oklahoma State Department of Health, Oklahoma City, Oklahoma
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  • Nathaniel Cobb MD,

    Corresponding author
    1. Indian Health Service, Division of Epidemiology and Disease Prevention, Albuquerque, New Mexico
    • Division of Epidemiology and Disease Prevention, Indian Health Service, 5300 Homestead NE, Albuquerque, NM 87110
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    • Fax: (505) 248-4393

  • Teshia Solomon PhD,

    1. Native American Research and Training Center, Department of Family and Community Medicine, University of Arizona, Tucson, Arizona
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  • Kym Cravatt MPH,

    1. Cancer Prevention and Control, Cherokee Nation, Tahlequah, Oklahoma
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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, Albuquerque, New Mexico
    2. Division of Epidemiology and Disease Prevention, Indian Health Service, Albuquerque, New Mexico
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  • LaTisha Marshall MPH,

    1. Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Janis Campbell PhD

    1. Chronic Disease Services, Oklahoma State Department of Health, Oklahoma City, Oklahoma
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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.

Lung cancer incidence rates among American Indians and Alaska Natives (AI/ANs) in the United States have not been described well, primarily because of race misclassification and, until the 1990s, incomplete coverage of their population by cancer registries. Smoking, the predominant cause of lung cancer, is particularly prevalent among this population.

METHODS.

Data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age-adjusted incidence rates of lung cancer during 1999 through 2004. Cases were linked to Indian Health Service (IHS) registration databases to identify AI/ANs whose race may have been misclassified. Age-adjusted rates were calculated for Contract Health Service Delivery Area (CHSDA) counties and for all counties by IHS region, and comparisons were made between AI/ANs and non-Hispanic whites (NHWs).

RESULTS.

Among populations living in CHSDA counties, NHWs overall had higher rates of lung cancer than AI/ANs. However, the rates (per 100,000 population) among AI/ANs varied substantially between IHS regions from 14.9 (Southwest) to 87.1 (Southern Plains), 93.2 (Alaska), and 104.3 (Northern Plains). Approximately 41.6% of AI/AN lung cancer cases were diagnosed before age 65 years compared with approximately 29.8% of NHW lung cancer cases. The overall percentage stage distribution was not different between AI/ANs and NHWs. Squamous cell carcinomas were slightly more common and adenocarcinomas were less common among AI/ANs than among NHWs. Lung cancer rates were not decreasing for AI/ANs as they were for NHWs.

CONCLUSIONS.

Data from this study clarified the need for culturally appropriate tobacco prevention and control policies and resources for AI/ANs in all regions, and especially in the Plains and Alaska. Cancer 2008;113(5 suppl):1168–78. Published 2008 by the American Cancer Society.

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