#111 Assessing and improving the quality of cancer surveillance data for american indians in the surveillance, epidemiology, and end results (Seer) Program

Changing patterns of gallbladder carcinoma in New Mexico

BACKGROUND

American Indians in the U.S. have a high incidence of gallbladder carcinoma (GBC). Furthermore, American Indians in New Mexico (NM) have the highest incidence rate of GBC in the U.S. The epidemiology of GBC in NM has not been studied in the past 3 decades.

METHODS

By using the NM Tumor Registry (NMTR) and the Surveillance, Epidemiology, and End Results (SEER) database, age-specific incidence rates, average annual age-adjusted incidence rates, and incidence rate time trends of GBC were compared among the three major ethnic groups in NM: American Indians, Hispanics, and non-Hispanic whites, for the period 1973-2001.

RESULTS

A sharp increase in GBC incidence occurred with advanced age and started earlier in American Indians (at age 55) than Hispanics (at age 60) than non-Hispanic whites (at age 65). GBC occurred more frequently in females than in males in all ethnic groups. In females, the incidence of GBC was the highest in American Indians (14.5 per 100,000) followed by Hispanics (6.8 per 100,000) and non-Hispanic whites (1.4 per 100,000). Similarly in males, American Indians had the highest incidence rate of GBC (7.8 per 100,000), followed by Hispanics (2.0 per 100,000), and non-Hispanic whites (1.0 per 100,000). The time trend analysis revealed that there has been a disproportionate decline in the incidence of GBC in the three ethnic groups, with the greatest drop in American Indians and Hispanics followed by non-Hispanic whites. Despite the decline, American Indians continued to have the highest incidence rate of GBC in NM.

CONCLUSION

The incidence of GBC has declined disproportionately in the three major ethnic groups, with the greatest decrease in American Indians and Hispanics followed by non-Hispanic whites.

Cancer rates among American Indians and Alaska Natives: is there a national perspective

BACKGROUND

Two important goals of cancer surveillance are to provide milestones in the effort to reduce the cancer burden and to generate observations that form the basis for cancer research and intervention for cancer prevention and control. Determination of the cancer burden among American Indians and Alaska Natives (AIAN) has been difficult largely due to lack of data collection efforts in many areas of the country and misclassification of racial data that results in undercounting of Native Americans. There is a revitalized commitment to improve data collection among the national agencies and organizations.

METHODS

Data on cancer trends from 12 areas covered by the Surveillance, Epidemiology and End Results (SEER) Program were reviewed for incidence and death rates for 1992-2000. AIAN trends were examined and compared with trends among other racial/ethnic population groups. Reference was made to studies of disease-specific survival for nine of the SEER areas for 1988-1997.

RESULTS

In SEER areas, cancer incidence rates for AIAN populations appeared to be decreasing significantly for lung and breast cancers among women and for prostate cancer among men. However, death rates rose, although not significantly, over the same period, except for a significant decrease in prostate cancer. Among the cancers with rising death rates were lung cancer (AIAN women) and colorectal cancer (AIAN men). In addition, survival often was lower for AIAN populations.

CONCLUSIONS

Although the incidence was stable or decreased among AIAN populations, increased death rates and lower survival rates indicate the need for intensified application of cancer prevention and control measures, including screening and treatment. Difficulties in interpretation of data include small population size and substantial interregional differences in rates.