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Prostate cancer incidence among American Indian and Alaska Native men, US, 1999–2004
Author(s) -
Henderson Jeffrey A.,
Espey David K.,
Jim Melissa A.,
German Robert R.,
Shaw Kate M.,
Hoffman Richard M.
Publication year - 2008
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.23739
Subject(s) - medicine , demography , incidence (geometry) , prostate cancer , cancer registry , population , cancer , ethnic group , gerontology , prostate cancer screening , epidemiology , gynecology , prostate specific antigen , environmental health , physics , sociology , anthropology , optics
BACKGROUND. American Indian and Alaska Native (AI/AN) men experience lower incidence of prostate cancer than other race/ethnic populations in the US, but racial misclassification of AI/AN men threatens the validity of these estimates. To the authors' knowledge, little is known concerning prostate‐specific antigen (PSA) testing in AI/AN men. METHODS. The authors linked cancer registry data with Indian Health Service enrollment records to improve race classification. Analyses comparing cancer incidence rates and stage at diagnosis for AI/AN and non‐Hispanic white (NHW) men for 6 geographic regions focused on counties known to have less race misclassification. The authors also used Behavioral Risk Factors Surveillance System data to characterize PSA testing in AI/AN men. RESULTS. Prostate cancer incidence rates were generally lower in AI/AN than in NHW men for all regions combined (rate ratio of 0.68). However, regional variation was noted among AI/AN men, with incidence rates (per 100,000 population) ranging from 65.7 in the Southwest to 174.5 on the Northern Plains. The rate of distant stage disease was somewhat higher among AI/AN (7.8) than NHW (6.2) men. Nationally, AI/AN men were less likely than NHW men to have undergone recent PSA testing (48.4% vs 58.0%), with prominent regional variation in screening rates noted. CONCLUSIONS. Prostate cancer incidence rates and the proportion of men with recent PSA testing were lower for AI/AN men than for NHW men. However, incident rates and rate of distant stage varied by region more for AI/AN than for NHW. Further research is needed among AI/AN men to evaluate strategies for better understanding the causes of the regional variation in prostate cancer incidence. Cancer 2008;113(5 suppl):1203–12. Published 2008 by the American Cancer Society.