title: Look local: the value of cancer surveillance and reporting by American Indian clinics.
abstract: BACKGROUND
  Cancer incidence and mortality rates for American Indians in the Northern Plains region of the United States are among the highest in the nation. Reliable cancer surveillance data are essential to help reduce this burden; however, racial data in state cancer registries are often misclassified, and cases are often underreported.
  
  
  METHODS
  We used a community-based participatory research approach to conduct a retrospective ascertainment of cancer cases in clinic medical records over a 9-year period (1995-2003) and compared the results with the state cancer registry to evaluate missing or racially misclassified cases. Six tribal and/or urban Indian clinics participated in the study. The project team consisted of participating clinics, a state cancer registry, a comprehensive cancer center, an American Indian/Alaska Native Leadership Initiative on Cancer, and a set of diverse organizational partners. Clinic personnel were trained by project staff to accurately identify cancer cases in clinic records. These records were then matched with the state cancer registry to assess misclassification and underreporting.
  
  
  RESULTS
  Forty American Indian cases were identified that were either missing or misclassified in the state registry. Adding these cases to the registry increased the number of American Indian cases by 21.3% during the study period (P = .05).
  
  
  CONCLUSIONS
  Our results indicate that direct reporting of cancer cases by tribal and urban Indian health clinics to a state cancer registry improved the quality of the data available for cancer surveillance. Higher-quality data can advance the efforts of cancer prevention and control stakeholders to address disparities in Native communities.
authors.affiliation: University of Wisconsin Department of Population Health Sciences, Madison, Wisconsin.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Creswell
authors.forename: Rick
authors.initials: R
authors.lastname: Strickland
authors.forename: Laura
authors.initials: L
authors.lastname: Stephenson
authors.forename: Kimmine
authors.initials: K
authors.lastname: Pierce-Hudson
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Matloub
authors.forename: Jerry
authors.initials: J
authors.lastname: Waukau
authors.forename: Alexandra
authors.initials: A
authors.lastname: Adams
authors.forename: Judith
authors.initials: J
authors.lastname: Kaur
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Remington
mesh_terms: D055812:Community-Based Participatory Research; D003191:Comprehensive Health Care; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D019221:Mandatory Reporting; D009369:Neoplasms / Q000453:epidemiology*; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018571:Sentinel Surveillance; D012959:Socioeconomic Factors; D019037:Urban Health Services / Q000706:statistics & numerical data