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Cancer among American Indians and Alaska Natives in the United States, 1999-2004.

https://arctichealth.org/en/permalink/ahliterature92380
Source
Cancer. 2008 Sep 1;113(5 Suppl):1142-52
Publication Type
Article
Date
Sep-1-2008
Author
Wiggins Charles L
Espey David K
Wingo Phyllis A
Kaur Judith S
Wilson Robin Taylor
Swan Judith
Miller Barry A
Jim Melissa A
Kelly Janet J
Lanier Anne P
Author Affiliation
New Mexico Tumor Registry, University of New Mexico Cancer Center, Albuquerque, New Mexico 87131-0001, USA. cwiggins@salud.unm.edu
Source
Cancer. 2008 Sep 1;113(5 Suppl):1142-52
Date
Sep-1-2008
Language
English
Publication Type
Article
Keywords
Alaska - epidemiology
Continental Population Groups - statistics & numerical data
Female
Humans
Incidence
Indians, North American - statistics & numerical data
Inuits - statistics & numerical data
Male
Neoplasms - ethnology
Registries
Time Factors
United States - epidemiology
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 are explained by race misclassification.
PubMed ID
18720375 View in PubMed
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Measures of racial/ethnic health disparities in cancer mortality rates and the influence of socioeconomic status.

https://arctichealth.org/en/permalink/ahliterature93939
Source
J Natl Med Assoc. 2007 Oct;99(10):1092-100, 1102-4
Publication Type
Article
Date
Oct-2007
Author
Chu Kenneth C
Miller Barry A
Springfield Sanya A
Author Affiliation
Center to Reduce Cancer Health Disparities, National Cancer Institute, Bethesda, MD, USA. kc10d@nih.gov
Source
J Natl Med Assoc. 2007 Oct;99(10):1092-100, 1102-4
Date
Oct-2007
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Ethnic Groups
Female
Health Status Disparities
Humans
Male
Middle Aged
Neoplasms - ethnology - mortality
Retrospective Studies
Risk factors
Sex Distribution
Social Class
Survival Rate - trends
United States - epidemiology
Abstract
OBJECTIVES: In the 1990s, U.S. cancer mortality rates declined due to reductions in tobacco use among men and beneficial cancer interventions, such as mammography and Pap smears. We examined the cancer rates by racial/ethnic group, socioeconomic status and time period to identify disparities underlying the overall mortality trend. METHODS: We examined racial/ethnic disparities by measuring excess cancer burden [rate ratio (RR) and ratio differences (RD)] and trends in their cancer rates for nine cancer sites. The trend (T) is calculated as a ratio of the average annual cancer mortality rate for 1995-2000 relative to the rate for 1990-1994 for three levels of poverty (counties with or =20%) for the major racial/ethnic populations. We also compared the trend for each racial/ethnic SES group to the trend for lowest SES white group (TD). RESULTS: Blacks have RR disparities relative to whites for each cancer site examined, except for female lung cancer, while the other minorities had RR disparities for cervical cancer (RR>1). There are increases in RR disparities from 1990-1994 to 1995-2000 (RD>0) for colorectal cancer, prostate cancer and breast cancer for each racial/ethnic minority. Whites and blacks had declining trends for every SES group (T1). In contrast, American Indians/Alaska natives, Hispanics and Asians/ Pacific Islanders had increasing trends for some of their cancer sites, and their trends did not have the SES gradients. CONCLUSIONS: Increases in racial/ethnic disparities (RD>0) for colorectal, breast and prostate cancer were largest in the lowest SES groups. At some cancer sites, the highest SES group for minorities had worse trend results than the trends for the lowest SES white group (TD>0).
PubMed ID
17987912 View in PubMed
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Methods for improving cancer surveillance data in American Indian and Alaska Native populations.

https://arctichealth.org/en/permalink/ahliterature92382
Source
Cancer. 2008 Sep 1;113(5 Suppl):1120-30
Publication Type
Article
Date
Sep-1-2008
Author
Espey David K
Wiggins Charles L
Jim Melissa A
Miller Barry A
Johnson Christopher J
Becker Tom M
Author Affiliation
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia. david.espey@ihs.gov
Source
Cancer. 2008 Sep 1;113(5 Suppl):1120-30
Date
Sep-1-2008
Language
English
Publication Type
Article
Keywords
Alaska - epidemiology
Continental Population Groups - classification
Data Collection
Humans
Incidence
Indians, North American - statistics & numerical data
Inuits - statistics & numerical data
Neoplasms - ethnology
Population Surveillance - methods
Registries
United States - epidemiology
United States Indian Health Service
Abstract
BACKGROUND: The misclassification of race decreases the accuracy of cancer incidence data for American Indians and Alaska Natives (AI/ANs) in some central cancer registries. This article describes the data sources and methods that were used to address this misclassification and to produce the cancer statistics used by most of the articles in this supplement. METHODS: Records from United States cancer registries were linked with Indian Health Service (IHS) records to identify AI/AN cases that were misclassified as non-AI/AN. Data were available from 47 registries that linked their data with IHS, met quality criteria, and agreed to participate. Analyses focused on cases among AI/AN residents in IHS Contract Health Service Delivery Area (CHSDA) counties in 33 states. Cancer incidence and stage data were compiled for non-Hispanic whites (NHWs) and AI/ANs across 6 IHS regions of the United States for 1999 through 2004. RESULTS: Misclassification of AI/AN race as nonnative in central cancer registries ranged from 85 individuals in Alaska (3.4%) to 5297 individuals in the Southern Plains (44.5%). Cancer incidence rates among AI/ANs for all cancers combined were lower than for NHWs, but incidence rates varied by geographic region for AI/ANs. Restricting the rate calculations to CHSDA counties generally resulted in higher rates than those obtained for all counties combined. CONCLUSIONS: The classification of race for AI/AN cases in cancer registries can be improved by linking records to the IHS and stratifying by CHSDA counties. Cancer in the AI/AN population is clarified further by describing incidence rates by geographic region. Improved cancer surveillance data for AI/AN communities should aid in the planning, implementation, and evaluation of more effective cancer control and should reduce health disparities in this population.
PubMed ID
18720372 View in PubMed
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Quality of race, Hispanic ethnicity, and immigrant status in population-based cancer registry data: implications for health disparity studies.

https://arctichealth.org/en/permalink/ahliterature79167
Source
Cancer Causes Control. 2007 Mar;18(2):177-87
Publication Type
Article
Date
Mar-2007
Author
Clegg Limin X
Reichman Marsha E
Hankey Benjamin F
Miller Barry A
Lin Yi D
Johnson Norman J
Schwartz Stephen M
Bernstein Leslie
Chen Vivien W
Goodman Marc T
Gomez Scarlett L
Graff John J
Lynch Charles F
Lin Charles C
Edwards Brenda K
Author Affiliation
Office of Healthcare Inspections, Office of Inspector General, US Department of Veterans Affairs, Washington, DC 20001, USA. lin.clegg@va.gov
Source
Cancer Causes Control. 2007 Mar;18(2):177-87
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
American Native Continental Ancestry Group
Bias (epidemiology)
Continental Population Groups - classification - statistics & numerical data
Emigration and Immigration - classification - statistics & numerical data
Female
Hispanic Americans - classification
Humans
Kaplan-Meiers Estimate
Longitudinal Studies
Male
Mortality
Population Surveillance
Quality Control
SEER Program - classification - standards - statistics & numerical data
Sensitivity and specificity
United States - epidemiology - ethnology
Abstract
Population-based cancer registry data from the Surveillance, Epidemiology, and End Results (SEER) Program at the National Cancer Institute are based on medical records and administrative information. Although SEER data have been used extensively in health disparities research, the quality of information concerning race, Hispanic ethnicity, and immigrant status has not been systematically evaluated. The quality of this information was determined by comparing SEER data with self-reported data among 13,538 cancer patients diagnosed between 1973-2001 in the SEER--National Longitudinal Mortality Study linked database. The overall agreement was excellent on race (kappa = 0.90, 95% CI = 0.88-0.91), moderate to substantial on Hispanic ethnicity (kappa = 0.61, 95% CI = 0.58-0.64), and low on immigrant status (kappa = 0.21. 95% CI = 0.10, 0.23). The effect of these disagreements was that SEER data tended to under-classify patient numbers when compared to self-identifications, except for the non-Hispanic group which was slightly over-classified. These disagreements translated into varying racial-, ethnic-, and immigrant status-specific cancer statistics, depending on whether self-reported or SEER data were used. In particular, the 5-year Kaplan-Meier survival and the median survival time from all causes for American Indians/Alaska Natives were substantially higher when based on self-classification (59% and 140 months, respectively) than when based on SEER classification (44% and 53 months, respectively), although the number of patients is small. These results can serve as a useful guide to researchers contemplating the use of population-based registry data to ascertain disparities in cancer burden. In particular, the study results caution against evaluating health disparities by using birthplace as a measure of immigrant status and race information for American Indians/Alaska Natives.
PubMed ID
17219013 View in PubMed
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