title: Regional differences and tribal use of American Indian/Alaska Native cancer data in the Pacific Northwest.
abstract: 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.
authors.affiliation: Northwest Tribal Epidemiology Center, Northwest Portland Area Indian Health Board, 2121 SW Broadway Drive, Suite 300, Portland, OR 97201, USA. mhoopes@npaihb.org
authors.forename: Megan J
authors.initials: MJ
authors.lastname: Hoopes
authors.forename: Paneen
authors.initials: P
authors.lastname: Petersen
authors.forename: Eric
authors.initials: E
authors.lastname: Vinson
authors.forename: Kerri
authors.initials: K
authors.lastname: Lopez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003625:Data Collection; D055088:Early Detection of Cancer; D005260:Female; D005843:Geography; D006801:Humans; D007061:Idaho / Q000453:epidemiology; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D054525:Minority Health / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000453:epidemiology* / Q000208:ethnology; D015205:Northwestern United States / Q000453:epidemiology; D009922:Oregon / Q000453:epidemiology; D012042:Registries / Q000706:statistics & numerical data*; D012306:Risk; D014481:United States / Q000453:epidemiology; D016549:United States Indian Health Service; D014861:Washington / Q000453:epidemiology; D055815:Young Adult