Incidence of Selected Cancers in Non-Hispanic American Indian and Alaska Native Adolescent and Young Adult Populations, 1999–2019

Elsevier

Available online 28 April 2023

Annals of EpidemiologyAuthor links open overlay panel, , , , AbstractPurpose

Studies have highlighted geographic variation in cancer incidence rates among American Indian and Alaska Native (AI/AN) populations. This is the first study to comprehensively evaluate incidence rates and trends among non-Hispanic AI/AN (NH-AI/AN) adolescents and young adults (AYAs) ages 15-39 years.

Methods

Using the United States Cancer Statistics AI/AN Incidence Analytic Database, we identified all malignant cancer cases for NH-AI/AN AYA populations for the years 1999-2019. We calculated age-adjusted incidence rates (per 100,000) for NH-AI/AN populations overall, by region, and by age group. We calculated total percent change in incidence of leading AYA cancers between 1999-2019, and trends by region and cancer type using Joinpoint analysis.

Results

Testicular (13.6) and breast (19.0) cancers had the highest incidence of all AYA cancers in NH-AI/AN males and females, respectively. Overall AYA cancer rates increased by 1.4% in NH-AI/AN males and 1.8% in NH-AI/AN females annually between 1999-2019. Increases were observed by age group and geographic region.

Conclusion

This study describes regional differences in incidence rates of AYA cancers among NH-AI/AN populations. This data can help inform resource and cancer control priorities and strategies to reduce cancer risk and enhance access to quality diagnostic and treatment services for this population.

Section snippetsINTRODUCTION

Previous studies have highlighted the importance of disaggregating cancer incidence data for American Indian and Alaska Native (AI/AN) populations in the United States by sex, cancer type and geographic region [1], [2], [3] to fully characterize cancer incidence in this diverse racial group. Limited information is available on incidence rates and trends for cancers among AI/AN adolescent and young adult (AYA) populations, despite growing evidence that the overall incidence of AYA cancers is

Cancer Cases

We utilized cancer registry data from the Centers for Disease Control and Prevention’s (CDC) National Program of Cancer Registries (NPCR) [9] and the National Cancer Institute’s (NCI) Surveillance, Epidemiology, and End Results (SEER) Program [10]. Incidence data from both registries must meet rigorous quality control standards for each diagnosis year [11]. Data from both registry programs are combined to create the U.S. Cancer Statistics American Indian and Alaska Native Incidence Analytic

RESULTS

Age-adjusted incidence rates and percent distribution for all AYA cancers and the 10 leading cancers among NH-AI/AN males and females are described in Table 1. The most common cancers among NH-AI/AN males were testicular cancer, lymphomas, colorectal cancer, leukemias, and kidney cancer. The top five cancers among NH-AI/AN females were female breast cancer, thyroid cancer, cervical cancer, uterine cancer, and colorectal cancer.

Rates for all AYA sites combined among NH-AI/AN males ranged from

DISCUSSION

Leading cancers among NH-AI/AN AYA populations varied by sex, with the top 10 cancers accounting for 86.8% (n=2,837) of AYA cancers among NH-AI/AN males and 82.8% (n=4,242) among NH-AI/AN females. These leading cancers were consistent with the general US population, however the relative ranks and rates varied [26]. The highest rate of all AYA cancers combined was in the Southern Plains and the lowest were in the East. Rates of sarcomas and CNS and other intracranial and intraspinal neoplasms in

Conclusion

This study describes rates of AYA cancers among NH-AI/AN populations and regional differences in the incidence of these cancers. Information on the incidence of AYA cancers can potentially be used to develop risk reduction strategies that are specific for this population. Strategies derived from research conducted in older or younger age groups may overlook important aspects of cancer risk among AYA populations. Additionally, work in this area may help researchers understand referral patterns

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgements

This work was supported by the Centers for Disease Control and Prevention

Disclaimer

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

No conflicts of interest to disclose.

Because the study did not involve human participants, institutional review board approval was not required.

Author Contribution

S. Melkonian conceptualized and designed the study; S. Melkonian, M. Jim, N. Said conducted data analysis

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