Regional Differences and Tribal Use of American Indian/Alaska Native Cancer Data in the Pacific Northwest
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In the Pacific Northwest, cancer is a leading cause of morbidity and mortality for American Indians and Alaska Natives (AI/AN). Misclassification of AI/AN race in state cancer registries causes cancer burden to be underestimated. Furthermore, local-level data are rarely available to individual tribes for use in health assessment and program planning. We corrected race coding in the cancer registries of Idaho, Oregon, and Washington using probabilistic record linkage to a file derived from patient registration records from Indian Health Service and a large urban clinic. We calculated cancer incidence and mortality measures by state, comparing AI/AN to non-Hispanic White (NHW) race. Record linkages identified a high prevalence of misclassified race. Differences in AI/AN cancer patterns were identified across the three state region. Compared to NHW, AI/AN experienced disproportionate late stage rates of some screen-detectable cancers. The correct classification of race is a crucial factor in cancer surveillance and can reveal regional differences even within a relatively small area. The availability of local-level cancer data can help inform tribes in appropriate intervention efforts.
KeywordsCancer Incidence Incidence-based mortality American Indian/Alaska Native Misclassification
The authors are grateful to the staff of the Urban Indian Health Institute, Cancer Data Registry of Idaho, and Oregon and Washington State Cancer Registries, for their collaboration and linkage-related support. Grant support for this project was received from National Cancer Institute’s Surveillance Research Program, contract #HHSN261201000335P, and the Indian Health Service Division of Epidemiology and Disease Prevention.
Conflict of interest
The authors declare that they do not have a conflict of interest.
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