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Cancer Stage in American Indians and Alaska Natives Enrolled in Medicaid.

https://arctichealth.org/en/permalink/ahliterature289339
Source
Am J Prev Med. 2016 Sep; 51(3):368-72
Publication Type
Journal Article
Date
Sep-2016
Author
Scott V Adams
Andrea N Burnett-Hartman
Andrew Karnopp
Aasthaa Bansal
Stacey A Cohen
Victoria Warren-Mears
Scott D Ramsey
Author Affiliation
Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington. Electronic address: sadams@fredhutch.org.
Source
Am J Prev Med. 2016 Sep; 51(3):368-72
Date
Sep-2016
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Alaska Natives - statistics & numerical data
California - epidemiology
Female
Humans
Incidence
Indians, North American - statistics & numerical data
Male
Medicaid
Middle Aged
Neoplasm Staging
Neoplasms - epidemiology - ethnology
Oregon - epidemiology
Population Surveillance
Registries
United States
Washington - epidemiology
Abstract
Nationally, a greater proportion of American Indians and Alaska Natives (AI/ANs) are diagnosed with advanced-stage cancers compared with non-Hispanic whites. The reasons for observed differences in stage at diagnosis between AI/ANs and non-Hispanic whites remain unclear.
Medicaid, Indian Health Service Care Systems, and state cancer registry data for California, Oregon, and Washington (2001-2008, analyzed in 2014-2015) were linked to identify AI/ANs and non-Hispanic whites diagnosed with invasive breast, cervical, colorectal, lung, or prostate cancer. Logistic regression was used to estimate ORs and 95% CIs for distant disease versus local or regional disease, in AI/ANs compared with non-Hispanic white case patients.
A similar proportion of AI/AN (31.2%) and non-Hispanic white (35.5%) patients were diagnosed with distant-stage cancer in this population (AOR=1.03, 95% CI=0.88, 1.20). No significant differences in stage at diagnosis were found for any individual cancer site. Among AI/ANs, Indian Health Service Care Systems eligibility was not associated with stage at diagnosis.
In contrast to the general population of the U.S., among Medicaid enrollees, AI/AN race is not associated with later stage at diagnosis. Cancer survival disparities associated with AI/AN race that have been observed in the broader population may be driven by factors associated with income and health insurance that are also associated with race, as income and insurance status are more homogenous within the Medicaid population than within the broader population.
Notes
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PubMed ID
27020318 View in PubMed
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