© 1998 Oxford University Press
research-article |
Colorectal cancer incidence and survival among Alaska Natives, 1969–1993
aUniversity of Washington School of Medidne Seattle, WA, USA
bAlaska Area Native Health Seriice Anchorage, AK, USA
cUniversity of Washington School of Public Health and Community Medicine Seattle, WA, USA
Reprint requests to. TM Becker. FHCRC MP 381. 1124 Columbia. Seattle, WA 98104, USA
BACKGROUND: Although colorectal cancer rates are low among most groups of Native Americans in North America, rates for Alaska Natives have been substantially elevated compared with US rates for all races combined.
METHODS: To better describe the epidemiology of colorectal cancer incidence and survival among Alaska Natives, stratified by gender and tribal/ethnic affiliation, we examined data collected by the Alaska Native Cancer Registry 1969–1993. We calculated age-adjusted and age-specific incidence as well as actuarial survival rates, and examined histological type, site, stage at diagnosis, and treatment. We compared these data to colorectal cancer data from whites living in western Washington.
RESULTS: In all, 587 colorectal cancer cases were identified among Alaska Natives over the 25-year period, for an age-adjusted annual incidence rate of 71.4/100 000 in women, and 69.3/100 000 in men. Compared to Alaska Indians, colon cancer rates were significantly higher in Aleuts (relative risk [RR] = 1.6, 95% CI: 1.2%2.2) and in Eskimos (RR = 1.5, 95% CI: 1.2–1.8), while rectal cancer rates did not differ by race/ethnicity. Alaska Natives experienced a 50% higher incidence rate of colorectal cancer overall compared to western Washington whites (RR 1.5, 95% Cl: 1.3%1.6), although rectal cancer rates were similar in the two populations. The highest RR were seen among Alaska Native women; Aleuts and Eskimos had colon cancer rates more than twice that of western Washington white women. No unusual qualitative features were found in the cancers occurring in Alaska Natives. Actuarial colorectal cancer survival rates for Alaska Natives overall were 74% at one year and 42% at 5 years; these rates were very similar to those observed for the western Washington population. Both one and 5-year survival rates showed a significant trend towards improvement over time.
CONCLUSIONS: Alaska Natives had substantially higher colorectal cancer incidence rates compared to western Washington whites. Rates were particularly high for Aleut and Eskimo women. These data suggest a need for intensified secondary prevention strategies for this high-risk population, while further research is needed to identify modifiable risk factors.
Keywords Colorectal neoplasms, Alaska Native, cross-cultural comparison
Accepted 28 August 1997
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  L. A. Boardman, A. P. Lanier, A. J. French, K. V. Schowalter, L. J. Burgart, K. R. Koller, S. K. McDonnell, D. J. Schaid, and S. N. Thibodeau Frequency of Defective DNA Mismatch Repair in Colorectal Cancer among the Alaska Native People Cancer Epidemiol. Biomarkers Prev., November 1, 2007; 16(11): 2344 - 2350. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Kelly, A. P. Lanier, S. Alberts, and C. L. Wiggins Differences in Cancer Incidence among Indians in Alaska and New Mexico and U.S. Whites, 1993-2002. Cancer Epidemiol. Biomarkers Prev., August 1, 2006; 15(8): 1515 - 1519. [Abstract] [Full Text] [PDF]
|
|