Dataset Information

Disparities of cancer incidence in Michigan's American Indians: spotlight on breast cancer.

ABSTRACT: In American Indians (AIs), cancer is a leading cause of mortality, yet their disease burden is not fully understood due to unaddressed racial misclassification in cancer registries. This study describes cancer trends among AIs in Michigan, focusing on breast cancer, in a linked data set of Indian Health Service (IHS), tribal, and state cancer registry data adjusted for misclassification.AI status was based on reported race and linkage to IHS data and tribal registries. Data with complete linkage on all incident cancer cases in Michigan from 1995 to 2004 was used to calculate age-standardized incidence estimates for invasive all-site and female breast cancers stratified by racial group. For female breast cancers, stage- and age-specific incidence and percent distributions of early- versus late-stage cancers and age of diagnosis were calculated.More than 50% of all AI cases were identified through IHS and/or tribal linkage. In the linked data, AIs had the lowest rates of all-sites and breast cancer. For breast cancers, AI women had a greater late-stage cancer burden and a younger mean age of diagnosis as compared to whites. Although the age-specific rate for whites was greater than for AI women in nearly all age groups, the difference in hazard ratio increased with increasing age.Our state-specific information will help formulate effective, tailored cancer prevention strategies to this population in Michigan. The data linkages used in our study are crucial for generating accurate rates and can be effective in addressing misclassification of the AI population and formulating cancer prevention strategies for AI nationwide.

SUBMITTER: Roen EL

PROVIDER: S-EPMC4147948 | biostudies-other | 2014 Jun

REPOSITORIES: biostudies-other

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Disparities of cancer incidence in Michigan's American Indians: spotlight on breast cancer.

Roen Emily L EL Copeland Glenn E GE Pinagtore Noel L NL Meza Rafael R Soliman Amr S AS

Cancer 20140326 12

<h4>Background</h4>In American Indians (AIs), cancer is a leading cause of mortality, yet their disease burden is not fully understood due to unaddressed racial misclassification in cancer registries. This study describes cancer trends among AIs in Michigan, focusing on breast cancer, in a linked data set of Indian Health Service (IHS), tribal, and state cancer registry data adjusted for misclassification.<h4>Methods</h4>AI status was based on reported race and linkage to IHS data and tribal reg ...[more]

PMID: 24676851

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Project description:Background:In the United States, the mortality burden of injury is higher among American Indians and Alaska Natives (AI/AN) than any other racial/ethnic group, and injury contributes to considerable medical costs, years of potential life lost (YPLL), and productivity loss among AI/AN.This study assessed the economic burden of injuries for AI/AN who are eligible for services through Indian Health Service, analyzing direct medical costs of injury for Indian Health Service's users and years of potential life lost (YPLL) and the value of productivity losses from injury deaths for AI/AN in the Indian Health Service population. Methods:Injury-related lifetime medical costs were estimated for Indian Health Service users with medically treated injuries using data from the 2011-2015 National Data Warehouse. Productivity costs and YPLL were estimated using data on injury-related deaths among AI/AN in Indian Health Service's 2008-2010 service population. Costs were reported in 2017?U.S. dollars. Results:The total estimated costs of injuries per year, including injuries among Indian Health Service users and productivity losses from injury-related deaths, were estimated at $4.5 billion. Lifetime medical costs to treat annual injuries among Indian Health Service users were estimated at $549 million, with the largest share ($131 million) going toward falls, the most frequent injury cause. Total estimated YPLL from AI/AN injury deaths in Indian Health Service's service population were 106,400. YPLL from injury deaths for men (74,000) were 2.2 times YPLL for women (33,000). Productivity losses from all injury-related deaths were $3.9 billion per year. The highest combined lifetime medical and mortality costs were for motor vehicle/traffic injuries, with an estimated cost of $1.6 billion per year. Conclusions:Findings suggest that targeted injury prevention efforts by Indian Health Service likely contributed to lower rates of injury among AI/AN, particularly for motor vehicle/traffic injuries. However, because of remaining disparities in injury-related outcomes between AI/AN and all races in the United States, Indian Health Service should continue to monitor changes in injury incidence and costs over time, evaluate the impacts of previous injury prevention investments on current incidence and costs, and identify additional injury prevention investment needs.

Dataset Information

Disparities of cancer incidence in Michigan's American Indians: spotlight on breast cancer.

Publications

Disparities of cancer incidence in Michigan's American Indians: spotlight on breast cancer.

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