Improving Cancer Incidence Estimates for American Indians and Alaska Natives in the Pacific Northwest

Quality of race, Hispanic ethnicity, and immigrant status in population-based cancer registry data: implications for health disparity studies

“…In spite of our small sample size for this group, our findings are similar to those from prior studies that have demonstrated poorascertainment of AI/AN [27,28,35,[41][42][43]. Indian Health Service data have been used to improve identification of AI/AN patients [35,[41][42][43] but this may be of limited value for AI/AN patients who are living in urban areas or who otherwise do not seek care with the Indian Health Service. As a result, there are ongoing efforts in SEER registries to use tribal enrollment databases to achieve better identification of AI/AN patients.…”

Regional differences in cervical cancer incidence among American Indians and Alaska Natives, 1999-2004

“…[18][19][20][21] Although linkages between cancer registry data and the IHS patient registration database improve the race classification for AI/AN cases, AI/AN persons who are not members of the federally recognized tribes, live primarily in urban settings, live long distances from IHS facilities, live in counties other than those designated as CHSDA, or are not eligible for IHS services are under-represented in the IHS database. Additional details regarding the misclassification of AI/AN race are available elsewhere in this supplement.…”

“…5,9,[15][16][17] Despite studies from limited geographic regions, AI/AN women have often been excluded from national and state reporting on cervical cancer because of race misclassification in central cancer registries. [18][19][20][21] The purpose of the current study was to improve our characterization of invasive cervical cancer incidence and stage at diagnosis in AI/AN women relative to NHW women, using techniques to minimize the effect of race misclassification in cancer surveillance data.…”

Gastric cancer among American Indians and Alaska Natives in the United States, 1999-2004

“…However, previous studies have demonstrated that registries often misclassify AI/ANs as other races. [11][12][13][14] For the current analysis, cancer registry records were linked with IHS patient services files to address this problem, because AI/AN individuals must provide proof of membership in a federally recognized tribe to receive healthcare from the IHS. 18 IHS provision of healthcare to AI/AN populations is considered to be greatest in Contract Health Service Delivery Area (CHSDA) counties, which generally are defined as those counties that contain or are adjacent to federally recognized tribal reservations and/or trust lands.…”

“…9,10 In the Southwestern US and in Alaska, incidence rates for gastric cancer among AI/AN populations remain high despite declining rates in other racial/ethnic populations from the same regions. 9,10 However, it is likely that misclassification of AI/ANs as other races in central cancer registries [11][12][13][14] resulted in an underestimate of the true burden of gastric cancer in these populations.…”