Trends in Cancer Incidence Among American Indians and Alaska Natives and Non-Hispanic Whites in the United States, 1999–2015. Issue 2 (March 2020)

• Record Type: Journal Article
• Authors: Gopalani, Sameer V.; Janitz, Amanda E.; Martinez, Sydney A.; Gutman, Pamela; Khan, Sohail; Campbell, Janis E.
• Is Part Of: Epidemiology. Volume 31:Issue 2(2020)
• Publication Date: 2020-03
• Subjects: American Indian and Alaska Native -- Breast cancer -- Colorectal cancer -- Lung cancer -- Prostate cancer -- Racial disparity; Epidemiology -- Periodicals; Epidemiology -- Environmental aspects -- Periodicals; Epidemiology -- Periodicals; 614.405
• DOI: 10.1097/EDE.0000000000001140
• Languages: English
• ISSNs: 1044-3983

Abstract

Abstract : Background: Female breast, prostate, lung, and colorectal cancers are the leading incident cancers among American Indian and Alaska Native (AI/AN) and non-Hispanic White (NHW) persons in the United States. To understand racial differences, we assessed incidence rates, analyzed trends, and examined geographic variation in incidence by Indian Health Service regions. Methods: To assess differences in incidence, we used age-adjusted incidence rates to calculate rate ratios (RRs) and 95% confidence intervals (CIs). Using joinpoint regression, we analyzed incidence trends over time for the four leading cancers from 1999 to 2015. Results: For all four cancers, overall and age-specific incidence rates were lower among AI/ANs than NHWs. By Indian Health Service regions, incidence rates for lung cancer were higher among AI/ANs than NHWs in Alaska (RR: 1.46; 95% CI: 1.37, 1.56) and Northern (RR: 1.29; 95% CI: 1.25, 1.33) and Southern (RR: 1.06; 95% CI: 1.03, 1.09) Plains. Similarly, colorectal cancer incidence rates were higher in AI/ANs than NHWs in Alaska (RR: 2.29; 95% CI: 2.14, 2.45) and Northern (RR: 1.04; 95% CI: 1.00, 1.09) and Southern (RR: 1.11; 95% CI: 1.07, 1.15) Plains. Also, AI/AN women in Alaska had a higher incidence rate for breast cancer than NHW women (RR: 1.05; 95% CI: 1.05, 1.20). From 1999 to 2015, incidence rates for all four cancers decreased in NHWs, but only rates for prostate (average annual percent change: –4.70) and colorectal (average annual percent change: –1.80) cancers decreased considerably in AI/ANs. Conclusion: Findings from this study highlight the racial and regional differences in cancer incidence. Abstract : Supplemental Digital Content is available in the text.