Regional differences in colorectal cancer incidence, stage, and subsite among American Indians and Alaska Natives, 1999-2004

David G. Perdue, Carin Perkins, Jeannette Jackson-Thompson, Steven Scott Coughlin, Faruque Ahmed, Donald S. Haverkamp, Melissa A. Jim

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

BACKGROUND. Colorectal cancer (CRC) is a leading cause of cancer morbidity and mortality for American Indians and Alaska Natives (AI/ANs), but misclassification of race causes underestimates of disease burden. METHODS. The authors compared regional differences in CRC incidence, stage at diagnosis, and anatomic distribution between AI/ANs and non-Hispanic whites (NHWs). To reduce misclassification, data from the National Program of Cancer Registries; the Surveillance, Epidemiology, and End Results Program; and the Indian Health Service (IHS) were linked. The analysis was limited to the 56% of AI/ AN who live in IHS Contract Health Service Delivery Areas. RESULTS. From 1999 to 2004, the overall incidence rate (per 100,000 persons per year) of CRC was 9% lower in the AI/AN population (46.3) than in the NHW population (50.8). However, AI/AN CRC incidence rates varied nearly 5-fold regionally, from 21 in the Southwest to 102.6 in Alaska. Compared with NHW rates, AI/AN rates were significantly higher in Alaska (rate ratio [RR], 2.03), the Northern Plains (RR, 1.39), and the Southern Plains (RR, 1.16) but were lower in the Pacific Coast (RR, 0.80), the East (RR, 0.65), and the Southwest (RR, 0.45). AI/ANs were diagnosed more often with advanced CRC than with localized CRC (RR, 1.92) compared with NHWs (RR, 1.48). Females more often had proximal CRC among both the AI/AN population (females, 40.1%; males, 33.5%) and the NHW population (females, 50.1%; males, 40.3%), although AI/ANs had a higher proportion of distal cancers overall. CONCLUSIONS. CRC incidence rates in AI/AN populations varied dramatically between regions. Efforts are needed to make CRC screening a priority, overcome barriers to endoscopic screening, and to engage AI/AN communities in culturally appropriate ways to participate in prevention and early detection programs.

Original languageEnglish (US)
Pages (from-to)1179-1190
Number of pages12
JournalCancer
Volume113
Issue number5 SUPPL.
DOIs
StatePublished - Sep 1 2008

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North American Indians
Colorectal Neoplasms
Incidence
United States Indian Health Service
Population
Contract Services
Catchment Area (Health)
Alaska Natives
SEER Program
Neoplasms
Early Detection of Cancer
Registries
Morbidity

Keywords

  • Cancer stage
  • Colonic subsite
  • Colorectal cancer
  • Epidemiology
  • Health disparities
  • Incidence
  • Indians of North America
  • Screening

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Perdue, D. G., Perkins, C., Jackson-Thompson, J., Coughlin, S. S., Ahmed, F., Haverkamp, D. S., & Jim, M. A. (2008). Regional differences in colorectal cancer incidence, stage, and subsite among American Indians and Alaska Natives, 1999-2004. Cancer, 113(5 SUPPL.), 1179-1190. https://doi.org/10.1002/cncr.23726

Regional differences in colorectal cancer incidence, stage, and subsite among American Indians and Alaska Natives, 1999-2004. / Perdue, David G.; Perkins, Carin; Jackson-Thompson, Jeannette; Coughlin, Steven Scott; Ahmed, Faruque; Haverkamp, Donald S.; Jim, Melissa A.

In: Cancer, Vol. 113, No. 5 SUPPL., 01.09.2008, p. 1179-1190.

Research output: Contribution to journalArticle

Perdue, DG, Perkins, C, Jackson-Thompson, J, Coughlin, SS, Ahmed, F, Haverkamp, DS & Jim, MA 2008, 'Regional differences in colorectal cancer incidence, stage, and subsite among American Indians and Alaska Natives, 1999-2004', Cancer, vol. 113, no. 5 SUPPL., pp. 1179-1190. https://doi.org/10.1002/cncr.23726
Perdue, David G. ; Perkins, Carin ; Jackson-Thompson, Jeannette ; Coughlin, Steven Scott ; Ahmed, Faruque ; Haverkamp, Donald S. ; Jim, Melissa A. / Regional differences in colorectal cancer incidence, stage, and subsite among American Indians and Alaska Natives, 1999-2004. In: Cancer. 2008 ; Vol. 113, No. 5 SUPPL. pp. 1179-1190.
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abstract = "BACKGROUND. Colorectal cancer (CRC) is a leading cause of cancer morbidity and mortality for American Indians and Alaska Natives (AI/ANs), but misclassification of race causes underestimates of disease burden. METHODS. The authors compared regional differences in CRC incidence, stage at diagnosis, and anatomic distribution between AI/ANs and non-Hispanic whites (NHWs). To reduce misclassification, data from the National Program of Cancer Registries; the Surveillance, Epidemiology, and End Results Program; and the Indian Health Service (IHS) were linked. The analysis was limited to the 56{\%} of AI/ AN who live in IHS Contract Health Service Delivery Areas. RESULTS. From 1999 to 2004, the overall incidence rate (per 100,000 persons per year) of CRC was 9{\%} lower in the AI/AN population (46.3) than in the NHW population (50.8). However, AI/AN CRC incidence rates varied nearly 5-fold regionally, from 21 in the Southwest to 102.6 in Alaska. Compared with NHW rates, AI/AN rates were significantly higher in Alaska (rate ratio [RR], 2.03), the Northern Plains (RR, 1.39), and the Southern Plains (RR, 1.16) but were lower in the Pacific Coast (RR, 0.80), the East (RR, 0.65), and the Southwest (RR, 0.45). AI/ANs were diagnosed more often with advanced CRC than with localized CRC (RR, 1.92) compared with NHWs (RR, 1.48). Females more often had proximal CRC among both the AI/AN population (females, 40.1{\%}; males, 33.5{\%}) and the NHW population (females, 50.1{\%}; males, 40.3{\%}), although AI/ANs had a higher proportion of distal cancers overall. CONCLUSIONS. CRC incidence rates in AI/AN populations varied dramatically between regions. Efforts are needed to make CRC screening a priority, overcome barriers to endoscopic screening, and to engage AI/AN communities in culturally appropriate ways to participate in prevention and early detection programs.",
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T1 - Regional differences in colorectal cancer incidence, stage, and subsite among American Indians and Alaska Natives, 1999-2004

AU - Perdue, David G.

AU - Perkins, Carin

AU - Jackson-Thompson, Jeannette

AU - Coughlin, Steven Scott

AU - Ahmed, Faruque

AU - Haverkamp, Donald S.

AU - Jim, Melissa A.

PY - 2008/9/1

Y1 - 2008/9/1

N2 - BACKGROUND. Colorectal cancer (CRC) is a leading cause of cancer morbidity and mortality for American Indians and Alaska Natives (AI/ANs), but misclassification of race causes underestimates of disease burden. METHODS. The authors compared regional differences in CRC incidence, stage at diagnosis, and anatomic distribution between AI/ANs and non-Hispanic whites (NHWs). To reduce misclassification, data from the National Program of Cancer Registries; the Surveillance, Epidemiology, and End Results Program; and the Indian Health Service (IHS) were linked. The analysis was limited to the 56% of AI/ AN who live in IHS Contract Health Service Delivery Areas. RESULTS. From 1999 to 2004, the overall incidence rate (per 100,000 persons per year) of CRC was 9% lower in the AI/AN population (46.3) than in the NHW population (50.8). However, AI/AN CRC incidence rates varied nearly 5-fold regionally, from 21 in the Southwest to 102.6 in Alaska. Compared with NHW rates, AI/AN rates were significantly higher in Alaska (rate ratio [RR], 2.03), the Northern Plains (RR, 1.39), and the Southern Plains (RR, 1.16) but were lower in the Pacific Coast (RR, 0.80), the East (RR, 0.65), and the Southwest (RR, 0.45). AI/ANs were diagnosed more often with advanced CRC than with localized CRC (RR, 1.92) compared with NHWs (RR, 1.48). Females more often had proximal CRC among both the AI/AN population (females, 40.1%; males, 33.5%) and the NHW population (females, 50.1%; males, 40.3%), although AI/ANs had a higher proportion of distal cancers overall. CONCLUSIONS. CRC incidence rates in AI/AN populations varied dramatically between regions. Efforts are needed to make CRC screening a priority, overcome barriers to endoscopic screening, and to engage AI/AN communities in culturally appropriate ways to participate in prevention and early detection programs.

AB - BACKGROUND. Colorectal cancer (CRC) is a leading cause of cancer morbidity and mortality for American Indians and Alaska Natives (AI/ANs), but misclassification of race causes underestimates of disease burden. METHODS. The authors compared regional differences in CRC incidence, stage at diagnosis, and anatomic distribution between AI/ANs and non-Hispanic whites (NHWs). To reduce misclassification, data from the National Program of Cancer Registries; the Surveillance, Epidemiology, and End Results Program; and the Indian Health Service (IHS) were linked. The analysis was limited to the 56% of AI/ AN who live in IHS Contract Health Service Delivery Areas. RESULTS. From 1999 to 2004, the overall incidence rate (per 100,000 persons per year) of CRC was 9% lower in the AI/AN population (46.3) than in the NHW population (50.8). However, AI/AN CRC incidence rates varied nearly 5-fold regionally, from 21 in the Southwest to 102.6 in Alaska. Compared with NHW rates, AI/AN rates were significantly higher in Alaska (rate ratio [RR], 2.03), the Northern Plains (RR, 1.39), and the Southern Plains (RR, 1.16) but were lower in the Pacific Coast (RR, 0.80), the East (RR, 0.65), and the Southwest (RR, 0.45). AI/ANs were diagnosed more often with advanced CRC than with localized CRC (RR, 1.92) compared with NHWs (RR, 1.48). Females more often had proximal CRC among both the AI/AN population (females, 40.1%; males, 33.5%) and the NHW population (females, 50.1%; males, 40.3%), although AI/ANs had a higher proportion of distal cancers overall. CONCLUSIONS. CRC incidence rates in AI/AN populations varied dramatically between regions. Efforts are needed to make CRC screening a priority, overcome barriers to endoscopic screening, and to engage AI/AN communities in culturally appropriate ways to participate in prevention and early detection programs.

KW - Cancer stage

KW - Colonic subsite

KW - Colorectal cancer

KW - Epidemiology

KW - Health disparities

KW - Incidence

KW - Indians of North America

KW - Screening

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