title: Kidney cancer incidence and mortality among American Indians and Alaska Natives in the United States, 1990-2009.
abstract: OBJECTIVE
  We describe rates and trends in kidney cancer incidence and mortality and identify disparities between American Indian/Alaska Native (AI/AN) and White populations.
  
  
  METHODS
  To improve identification of AI/AN race, incidence and mortality data were linked with Indian Health Service (IHS) patient records. Analysis focused on residents of IHS Contract Health Service Delivery Area counties; Hispanics were excluded. We calculated age-adjusted kidney cancer incidence (2001-2009) and death rates (1990-2009) by sex, age, and IHS region.
  
  
  RESULTS
  AI/AN persons have a 1.6 times higher kidney cancer incidence and a 1.9 times higher kidney cancer death rate than Whites. Despite a significant decline in kidney cancer death rates for Whites (annual percentage change [APC] = -0.3; 95% confidence interval [CI] = -0.5, 0.0), death rates for AI/AN persons remained stable (APC = 0.4; 95% CI = -0.7, 1.5). Kidney cancer incidence rates rose more rapidly for AI/AN persons (APC = 3.5; 95% CI = 1.2, 5.8) than for Whites (APC = 2.1; 95% CI = 1.4, 2.8).
  
  
  CONCLUSIONS
  AI/AN individuals have greater risk of developing and dying of kidney cancers. Incidence rates have increased faster in AI/AN populations than in Whites. Death rates have decreased slightly in Whites but remained stable in AI/AN populations. Racial disparities in kidney cancer are widening.
authors.affiliation: Jun Li, Hannah K. Weir, Melissa A. Jim, and Reda Wilson are with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA. Sallyann M. King is with the Division of Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, CDC. Viraj A. Master is with the Department of Urology and Winship Cancer Institute, School of Medicine, Emory University, Atlanta.
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Hannah K
authors.initials: HK
authors.lastname: Weir
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Jim
authors.forename: Sallyann M
authors.initials: SM
authors.lastname: King
authors.forename: Reda
authors.initials: R
authors.lastname: Wilson
authors.forename: Viraj A
authors.initials: VA
authors.lastname: Master
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000413:Alaska / Q000453:epidemiology / Q000208:ethnology; D002423:Cause of Death; D003644:Death Certificates; D005260:Female; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data*; D004930:Inuit / Q000706:statistics & numerical data*; D007680:Kidney Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012042:Registries; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
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