Breast cancer incidence among American Indian and Alaska Native women: US, 1999-2004

Phyllis A. Wingo, Jessica King, Judith Swan, Steven S. Coughlin, Judith S. Kaur, Julie A. Erb-Alvarez, Jeannette Jackson-Thompson, Teshia G. Arambula Solomon

Research output: Contribution to journalArticle

49 Scopus citations

Abstract

BACKGROUND. Breast cancer is a leading cause of cancer morbidity and mortality among American Indian and Alaska Native (AI/AN) women. Although published studies have suggested that breast cancer rates among AI/AN women are lower than those among other racial and ethnic populations, accurate determinations of the breast cancer burden have been hampered by misclassification of AI/AN race. METHODS. Cancer incidence data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program were combined to estimate age-adjusted rates for the diagnosis years 1999 through 2004. Several steps were taken to reduce the misclassification of AI/AN race: linking cases to Indian Health Service (IHS) patient services database, restricting analyses to Contract Health Service Delivery Area counties, and stratifying results by IHS region. RESULTS. Breast cancer incidence rates among AI/AN women varied nearly 3-fold across IHS regions. The highest rates were in Alaska (134.8) and the Plains (Northern, 115.9; Southern, 115.7), and the lowest rates were in the Southwest (50.8). The rate in Alaska was similar to the rate among non-Hispanic white (NHW) women in Alaska. Overall, AI/AN women had lower rates of breast cancer than NHW women, but AI/AN women were more likely to be diagnosed with late-stage disease. CONCLUSIONS. To the authors' knowledge, this report provides the most comprehensive breast cancer incidence data for AI/AN women to date. The wide regional variation indicates an important need for etiologic and health services research, and the large percentage of AI/AN women with late-stage disease demands innovative approaches for increasing access to screening.

Original languageEnglish (US)
Pages (from-to)1191-1202
Number of pages12
JournalCancer
Volume113
Issue number5 SUPPL.
DOIs
StatePublished - Sep 1 2008

Keywords

  • American Indian/Alaska Native
  • Breast cancer
  • Incidence
  • National program of cancer registries
  • Surveillance, Epidemiology, and End Results

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Wingo, P. A., King, J., Swan, J., Coughlin, S. S., Kaur, J. S., Erb-Alvarez, J. A., Jackson-Thompson, J., & Arambula Solomon, T. G. (2008). Breast cancer incidence among American Indian and Alaska Native women: US, 1999-2004. Cancer, 113(5 SUPPL.), 1191-1202. https://doi.org/10.1002/cncr.23725