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Prostate cancer incidence among American Indian and Alaska Native men, US, 1999-2004

TitleProstate cancer incidence among American Indian and Alaska Native men, US, 1999-2004
Publication TypeJournal Article
Year of Publication2008
AuthorsHenderson, JA, Espey, DK, Jim, MA, German, RR, Shaw, KM, Hoffman, RM
Date PublishedSep 1
ISBN Number0008-543X (Print)<br/>0008-543X (Linking)
Accession Number18720376
KeywordsAdenocarcinoma/ ethnology, Adult, Aged, Alaska/epidemiology, Continental Population Groups/statistics & numerical data, Humans, Incidence, Indians, North American/ statistics & numerical data, Inuits/ statistics & numerical data, Male, Middle Aged, Population Surveillance, Prostate-Specific Antigen/analysis, Prostatic Neoplasms/ ethnology, Registries, United States/epidemiology
AbstractBACKGROUND: 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.
Ethno Med: