title: Cancer disparities among Alaska native people, 1970-2011.
abstract: BACKGROUND
  Cancer is the leading cause of death among Alaska Native people. The objective of this study was to examine cancer incidence data for 2007-2011, age-specific rates for a 15-year period, incidence trends for 1970-2011, and mortality trends for 1990-2011.
  
  
  METHODS
  US data were from the Surveillance, Epidemiology, and End Results (SEER) Program SEER*Stat database and from the SEER Alaska Native Tumor Registry. Age-adjusted cancer incidence rates among Alaska Native people and US whites were compared using rate ratios. Trend analyses were performed using the Joinpoint Regression Program. Mortality data were from National Center for Health Statistics.
  
  
  RESULTS
  During 2007-2011 the cancer incidence rate among Alaska Native women was 16% higher than the rate among US white women and was similar among Alaska Native men and US white men. Incidence rates among Alaska Native people exceeded rates among US whites for nasopharyngeal, stomach, colorectal, lung, and kidney cancer. A downward trend in colorectal cancer incidence among Alaska Native people occurred from 1999 to 2011. Significant declines in rates were not observed for other frequently diagnosed cancers or for all sites combined. Cancer mortality rates among Alaska Native people during 2 periods, 1990-2000 and 2001-2011, did not decline. Cancer mortality rates among Alaska Native people exceeded rates among US whites for all cancers combined; for cancers of the lung, stomach, pancreas, kidney, and cervix; and for colorectal cancer.
  
  
  CONCLUSIONS
  Increases in colorectal screening among Alaska Native people may be responsible for current declines in colorectal cancer incidence; however; improvements in treatment of colon and rectal cancers may also be contributing factors.
authors.affiliation: Alaska Native Tribal Health Consortium, Alaska Native Epidemiology Center, Division of Community Health Services, 3900 Ambassador Dr, Anchorage, Alaska 99508. Telephone: 907-729-3949. E-mail: jjkelly@anthc.org.
authors.forename: Janet J
authors.initials: JJ
authors.lastname: Kelly
authors.affiliation: Alaska Native Tribal Health Consortium, Alaska Native Epidemiology Center, Division of Community Health Services, Anchorage, Alaska.
authors.forename: Anne P
authors.initials: AP
authors.lastname: Lanier
authors.affiliation: Alaska Native Tribal Health Consortium, Alaska Native Epidemiology Center, Division of Community Health Services, Anchorage, Alaska.
authors.forename: Teresa
authors.initials: T
authors.lastname: Schade
authors.affiliation: Alaska Native Tribal Health Consortium, Alaska Native Epidemiology Center, Division of Community Health Services, Anchorage, Alaska.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Brantley
authors.affiliation: Alaska Native Tribal Health Consortium, Alaska Native Epidemiology Center, Division of Community Health Services, Anchorage, Alaska.
authors.forename: B Michael
authors.initials: BM
authors.lastname: Starkey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000413:Alaska / Q000453:epidemiology; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data*; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D009309:National Center for Health Statistics, U.S.; D009361:Neoplasm Invasiveness / Q000175:diagnosis; D009369:Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality; D012042:Registries / Q000706:statistics & numerical data; D012044:Regression Analysis; D018426:SEER Program; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*