Growing Disparity in the Incidence of Colorectal Cancer Among Non-Hispanic American Indian and Alaska Native Populations-United States, 2013-2017
Overview
Oncology
Public Health
Affiliations
Background: American Indian and Alaska Native (AI/AN) populations have experienced regional variation and disparities in colorectal cancer incidence rates.
Methods: We examined colorectal cancer incidence (2013-2017) and colorectal cancer incidence trends (1999-2017) among AI/AN persons. Incidence data were linked to Indian Health Service enrollment records, and analyses were restricted to Purchased/Referred Care Delivery Areas. Incidence rates of colorectal cancer among AI/AN and White persons were analyzed in six geographic regions; Hispanic persons were excluded. Incidence trends were analyzed using linear modeling.
Results: During 2013-2017, colorectal cancer incidence was 41% higher among AI/AN than among White persons. AI/AN incidence rates per 100,000 varied regionally from 34.4 in the East to 96.1 in Alaska. Compared with White persons, AI/AN persons had higher colorectal cancer incidence rates among all age strata and were more likely to have late-stage diagnoses. Incidence rate trends indicated significant increases among both AI/AN and White persons ages <50 years and among AI/AN persons ages 50-64 years. The colorectal cancer incidence rate trend increased among AI/AN persons in the Southwest.
Conclusions: The disparity of colorectal cancer incidence rates between AI/AN and White persons has widened since 2005-2009. AI/AN populations have higher colorectal cancer incidence compared with White populations, especially in the Alaska region.
Impact: Our finding of increased colorectal cancer incidence disparities suggests that enhanced screening efforts and culturally appropriate clinical and public health interventions are needed among AI/AN persons overall, and especially in regions and age groups in which colorectal cancer rates are increasing.
Pankratz V, Kanda D, Kosich M, Edwardson N, English K, Adsul P Cancer Control. 2024; 31:10732748241300653.
PMID: 39543981 PMC: 11565617. DOI: 10.1177/10732748241300653.
Adekoya N, Chang M, Wortham J, Truman B Public Health Rep. 2023; 139(5):557-565.
PMID: 38111105 PMC: 11324802. DOI: 10.1177/00333549231213328.
Buchwald D, Bassett D, Van Dyke E, Harris R, Hanson J, Tu S BMC Cancer. 2023; 23(1):1036.
PMID: 37884866 PMC: 10601143. DOI: 10.1186/s12885-023-11245-y.
Melkonian S, Jim M, Reza A, Peipins L, Haverkamp D, Said N Am J Epidemiol. 2023; 193(1):58-74.
PMID: 37823258 PMC: 10990004. DOI: 10.1093/aje/kwad194.
Maybee W, Henry W, Lazore-Swan D, Abrams C, Attwood K, Vincent P J Cancer Educ. 2023; 39(1):65-69.
PMID: 37821663 PMC: 10799786. DOI: 10.1007/s13187-023-02376-8.