cancer in american indians in arizona
TRANSCRIPT
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
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%
Am J Public Health. 2014;104:S377–S387
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
Am J Public Health. 2014;104:S377–S387
Some cancers occur more frequently in AI than in the general American population, nationwide 1999-2012.
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
Am J Public Health. 2014;104:S377–S387
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
Am J Public Health. 2014;104:S377–S387
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