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A Critical Review of Methods for Assessing Cancer Survival Disparities in Indigenous Population

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.

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Citation

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.

Measuring Cancer in Indigenous Populations

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.

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Citation

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.

Cancer in First Nations People Living in British Columbia, Canada: An Analysis of Incidence and Survival from 1993 to 2010

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.

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Citation

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

Gastric Cancer Among American Indian and Alaska Native Populations in the United States, 2005-2016

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.

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Citation

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.

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