cancer in american indians in arizona

CANCER IN AMERICAN INDIANS IN ARIZONA

Christina Laukaitis, MD, PhDMedical Education Director

Native American Cancer Research Partnership Arizona Cancer Center

CANCER IS THE LEADING CAUSE OF DEATH IN AMERICAN INDIANS AND ALASKA NATIVES

National Vital Statistics Reports, Vol. 62, No. 6, December 20, 2013

CANCER IS A LEADING CAUSES OF DEATH FOR AIS IN ARIZONA

Cancer affects men and women differently

AZ Cancer Registry: http://www.azdhs.gov/plan/report/hspam/hspam06/part_5c.pdf

Cancer by Race/Ethnicity, Arizona, 2009-2012

2015 Arizona Cancer Registry, AZDHS

AMERICAN INDIANS IN AZ HAVE LOWER CANCER RATES THAN NON-AI

NEW CANCER CASES FOR AI BY AGE GROUP, ARIZONA, 2009-2012

2015 Arizona Cancer Registry, AZDHS

INCIDENT CANCERS, FEMALE

N A T I V E

1. Breast 25%2. Lung 15%3. Colon 12%4. Uterus 6%5. Kidney 4%6. NHL 4%7. Ovary 3%8. Thyroid 3%9. Cervix 3%10. Pancreas 3%

A L L

1. Breast 31%2. Lung 14%3. Colon 10%4. Uterus 6%5. Melanoma 5%6. NHL 4%7. Thyroid 4%8. Ovary 3%9. Pancreas 3%10. Leukemia 2%

Am J Public Health. 2014;104:S377–S387

INCIDENT CANCERS, MALES

N A T I V E

1. Prostate 25%2. Lung 16%3. Colon 13%4. Kidney 6%5. Bladder 4%6. NHL 4%7. Liver 3%8. Stomach 3%9. Oral 3%10. Leukemia 3%

A L L

1. Prostate 28%2. Lung 15%3. Colon 10%4. Bladder 8%5. Melanoma 5%6. NHL 4%7. Kidney 3%8. Leukemia 3%9. Oral 3%10. Pancreas 2%


CANCER RATE DIFFERENCES, AI V. ALL

MEN§Kidney/renal pelvis§ 30.2/18.7 = 1.62

§Liver§ 16.1/7.3 = 2.21

§Stomach§ 15.9/8.1 = 1.97

WOMEN§Kidney/renal pelvis§ 17.4/9.6 = 1.81

§ Cervix§ 11.0/7.1 = 1.55

§ Stomach§ 8.0/3.5 = 2.26

§ Liver § 7.7/2.6 = 2.95

§Myeloma § 6.2/3.9 = 1.57


Some cancers occur more frequently in AI than in the general American population, nationwide 1999-2012.

RATES OF CANCER ARE DECREASING, NATIONWIDE

SEER data, 2000-2012

ARIZONA CANCER MORTALITY, BY ETHNICITY

Differences in the Health Status Among Racial/Ethnic Groups, Arizona 2013

DEADLY CANCERS, WOMEN

N A T I V E

1. Lung2. Breast3. Colon4. Pancreas5. Ovary6. Liver7. NHL8. Stomach9. Kidney10. Cervix

W H I T E

1. Lung2. Breast3. Colon4. Pancreas5. Ovary6. NHL7. Uterus8. Brain9. Myeloma10. Liver


DEADLY CANCERS, MEN

N A T I V E

1. Lung2. Colon3. Prostate4. Liver5. Kidney6. Pancreas7. Stomach8. Esophagus9. NHL10. Brain

W H I T E

1. Lung2. Prostate3. Colon4. Pancreas5. NHL6. Esophagus7. Bladder8. Liver9. Brain 10. Kidney


CANCER MORTALITY IS DECREASING, NATIONWIDE

SEER data, 2000-2012

CANCER MORTALITY IS NOT DECREASING QUICKLY FOR AZ AI

AZ Cancer Registry: http://www.azdhs.gov/plan/report/hspam/hspam06/part_5c.pdf

2009 CANCER SCREENING RATES, IHS

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Pap/3y Mammo/2y Colon/1y

IHSPHOTUSNAVWhiteWhite, Uninsured

AI HAVE THE LOWEST RATES OF EARLY DIAGNOSIS OF ALL ARIZONANS

Good prognosis depends on early detection.

010203040506070

AI (1) AA (2) Hispanic White All

% D

iagn

osed

Ear

ly S

tage

Colorectal Breast Prostate Cervical

Source: Arizona Facts and Figures, 2004-2005; American Cancer Society

(1) AI = American Indian

(2) (2) AA= African American

Highest incidence

Highest late stage diagnosis

Highest mortality

28%

47%

13%

11%

Sources: Comprehensive Cancer Control Plan, AZ dept of Health Services, 2007, AZ Cancer Facts and Figures, 2004-2005, American Cancer Society

2%77%

2%

AZ Counties with the highest rates of mortality and late diagnosis have large AI populations.

County % AI

Navajo 47

Gila 13

La Paz 11

All Arizona 5

2%

LIMITATIONS OF THE DATA

Racial misclassification

Undercounting

Coding errors

Not enough numbers to form a conclusion

Cannot be generalized to peoples of other areas

SUMMARY

• Overall, cancer is less common in Native than white Arizonans

• Some cancers are more common in Native Arizonans• When it occurs, cancer is more deadly in Native

Arizonans• Modifiable factors may influence a Native person’s risk

of dying of cancer include • Exposures, • Screening, • Treatment

cancer in american indians in arizona

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