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Incidence of primary liver cancer in American Indians and Alaska Natives, US, 1999–2009

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Abstract

Purpose

To evaluate liver cancer incidence rates and risk factor correlations in non-Hispanic AI/AN populations for the years 1999–2009.

Methods

We linked data from 51 central cancer registries with the Indian Health Service patient registration databases to improve identification of the AI/AN population. Analyses were restricted to non-Hispanic persons living in Contract Health Service Delivery Area counties. We compared age-adjusted liver cancer incidence rates (per 100,000) for AI/AN to white populations using rate ratios. Annual percent changes (APCs) and trends were estimated using joinpoint regression analyses. We evaluated correlations between regional liver cancer incidence rates and risk factors using Pearson correlation coefficients.

Results

AI/AN persons had higher liver cancer incidence rates than whites overall (11.5 versus 4.8, RR = 2.4, 95% CI 2.3–2.6). Rate ratios ranged from 1.6 (Southwest) to 3.4 (Northern Plains and Alaska). We observed an increasing trend among AI/AN persons (APC 1999–2009 = 5%). Rates of distant disease were higher in the AI/AN versus white population for all regions except Alaska. Alcohol use (r = 0.84) and obesity (r = 0.79) were correlated with liver cancer incidence by region.

Conclusions

Findings highlight disparities in liver cancer incidence between AI/AN and white populations and emphasize opportunities to decrease liver cancer risk factor prevalence.

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Acknowledgments

This study was supported by the Centers for Disease Control and Prevention (CDC). We thank Brian McMahon, Brenna Simons-Petrusa, and Sarah H. Nash from the Alaska Native Tribal Health Consortium for their input in this article.

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily reflect the official position of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 1720 Louisiana Blvd NE, Suite 208, Albuquerque, NM, 87110, USA

    Stephanie C. Melkonian, Melissa A. Jim & Donald Haverkamp

  2. Northwest Portland Area Indian Health Board, Portland, OR, USA

    Brigg Reilley

  3. Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA

    Jennifer Erdrich

  4. Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Zahava Berkowitz & Mary C. White

  5. New Mexico Tumor Registry, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA

    Charles L. Wiggins

Authors
  1. Stephanie C. Melkonian
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  2. Melissa A. Jim
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  3. Brigg Reilley
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Corresponding author

Correspondence to Stephanie C. Melkonian.

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No conflicts of interest to disclose.

Ethical approval

The study did not involve human participants, institutional review board approval was not necessary.

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Melkonian, S.C., Jim, M.A., Reilley, B. et al. Incidence of primary liver cancer in American Indians and Alaska Natives, US, 1999–2009. Cancer Causes Control 29, 833–844 (2018). https://doi.org/10.1007/s10552-018-1059-3

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  • DOI: https://doi.org/10.1007/s10552-018-1059-3

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