Surveillance, Epidemiology and End Results (SEER) Program National Cancer Institute
National Program in Cancer Registries Center for Disease Control and Prevention
United States Cancer Statistics: Data Visualizations
Cancer Statistics Center American Cancer Society
Breast cancer is the most common type of malignant cancer diagnosed among American Indian and Alaska Native women. Dr. Sarah Nash and her colleagues examined female breast cancer in Alaska Native women during the time period 1969-2014. They found that a majority of these cancers were diagnosed among women over the age of 50 years, at local stage, and with Hormone Receptor-Positive (HR+)/Human Epidermal Growth Factor 2-Negative (HER2−) subtype. Incidence rates increased from 1969-2014, especially in the early years of the study period. This study provides a comprehensive update of our knowledge and understanding of breast cancer descriptive epidemiology among Alaska Native women, using data collected by the Alaska Native Tumor Registry.
Invasive breast cancer among Alaska Native women in Alaska. International Journal of Circumpolar Health. 2019; 78(1):1633190. doi: 10.1080/22423982.2019.1633190. PMID: 31234738.
In 2014, the American Journal of Public Health devoted an entire issue to examining the leading causes of death among American Indians and Alaska Natives (AI/AN). Dr. Mary White and her colleagues provided an overview of cancer mortality and incidence rates for all types of cancer-combined, and for several individual types of cancer. The report documented differences in cancer rates between AI/AN and non-Hispanic whites, as well as regional variations in cancer incidence and mortality rates among AI/AN populations, nationwide.
Disparities in Cancer Mortality and Incidence Among American Indians and Alaska Natives in the United States. American Journal of Public Health, 2014; 104(Suppl 3): S377–S387. doi: 10.2105/AJPH.2013.301673. PMID: 24754660.
For the purposes of this report, the authors critically reviewed 83 scientific articles that addressed cancer survival among indigenous persons in the United States, Canada, Australia and New Zealand. The authors summarized methodologic approaches that were utilized in these articles, and determined that well-known biases were oftne not addressed in these reports. This thoughtful review concludes by urging researchers to describe their data sources, to justify analytic choices, and to fully discuss the potential impact of their choices on the results and interpretation of findings.
Withrow DR, Racey CS, Jamal S. A Critical Review of Methods for Assessing Cancer Survival Disparities in Indigenous Population. Annals of Epidemiology 2016; 26(8): 579-591. DOI: 10.1016/j.annepidem.2016.06.007. PMID: 27431064.
There are many challenges to conducting accurate cancer surveillance in indigenous populations throughout the world. This manuscript provides an overview of factors that constrain measures of cancer incidence, mortality and survival among indigenous peoples, including: 1) suboptimal identification of indigenous populations; 2) numerator-denominator bias; 3) problems with data linkage in survival analysis; and 4) statistical analytic considerations. The authors identify steps that can be taken to address such challenges and, importantly, advocate for the full engagement of indigenous peoples in cancer surveillance endeavors.
Sarfati D, Garvey G, Robson B, Moore S, Cunnigham R, Withrow D, Griffiths K, Caron NR, Bray F. Measuring Cancer in Indigenous Populations. Annals of Epidemiology 2018; 28(5): 335-342. DOI: 10.1016/j.annepidem.2018.02.005. PMID: 29503062.
Gastric cancer incidence rates were reported for American Indian/Alaska Native (AI/AN) populations in six geographic regions in the United States during the time period 2005-2016. Rates for non-Hispanic whites (NHW) in each region were calculated for comparison. Rates were higher among AI/AN populations than among NHW in almost every region. Incidence rates for central/distal portions of the stomach were higher in AI/AN individuals compared with NHW, which likely reflects a high prevalence of Helicobacter pylori infection in AI/AN populations. The authors concluded that these results can be used to develop interventions to reduce risk factors and improve access to health services among AI/AN people at high risk for gastric cancer.
Melkonian SC, Pete D, Jim MA, Haverkamp D, Wiggins CL, Bruce MG, White MC. Gastric Cancer Among American Indian and Alaska Native Populations in the United States, 2005-2016. American Journal of Gastroenterology 2020; . PMID: 32740090. DOI: 10.14309/ajg.0000000000000748.
Average annual, age-adjusted cancer incidence rates and cause-specific survival estimates were reported for First Nations (FN) residents of British Columbia, Canada. Corresponding measures for non-First Nations (non-FN) residents of this region were reported for comparison purposes. Incidence rates of colorectal and cervical cancer were statistically elevated in FN compared to non-FN populations. Incidence rates for most other cancers were generally similar between the two groups, or lower in FN populations. Cause-specific survival was generally lower among FN than non-FN across multiple types of cancer. The authors concluded that additional research is needed to explore the likely multifaceted basis for these findings.
McGahan CE, Lin K, Guno P, Johnson H, Coldman AJ, Spinelli JJ, Caron NR. Cancer in First Nations People Living in British Columbia, Canada: An Analysis of Incidence and Survival from 1993 to 2010. Cancer Causes and Control 2017; 28: 1105-1116